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Int. braz. j. urol ; 42(3): 494-500, tab, graf
Artigo em Inglês | LILACS | ID: lil-785716

RESUMO

ABSTRACT Purpose to assess the efficacy of transcorporal artificial urinary sphincter (AUS) implantation on continence for male stress urinary incontinence in cases of prior surgical treatment or/and radiation failure, and as a first option in radiation patients. Materials and Methods From March 2007 to August 2012, 37 male patients were treated with transcorporal AUS AMS™ 800. Twelve patients had primary placement of transcorporal cuff, a surgical option due to a previous history of radiation and 25 patients had secondary procedure after failure of AUS or urinary incontinence surgery. Functional urinary outcomes were assessed by daily pad use, 24-hour Pad-test and ICIQ-SF questionnaire. Quality of life and satisfaction were assessed based on I-QoL and PGI-I questionnaires. Results After a median of 32 months, the continence rate (0 to 1 pad) was 69.7%. Median pad test was 17.5g (0-159), mean ICIQ-SF score was 7.3/21 (±5.4) and mean I-QoL score was 93.9/110. A total of 88% of the patients reported satisfaction with the AUS. The 5-year actuarial revision-free for AUS total device was 51%. Patients for primary implant for radiation were not more likely to experience revision than non-radiation patients. Preservation of erections was reported in half of the potent patients. Conclusions Transcorporal AUS cuff placement is a useful alternative procedure option for severe male UI treatment, especially in patients with a compromised urethra after prior surgery or radiation. A high continence rate was reported and implantation as first option in radiation patients should be considered.


Assuntos
Humanos , Masculino , Idoso , Uretra/cirurgia , Uretra/efeitos da radiação , Incontinência Urinária por Estresse/cirurgia , Esfíncter Urinário Artificial , Complicações Pós-Operatórias , Prostatectomia/efeitos adversos , Qualidade de Vida , Fatores de Tempo , Incontinência Urinária por Estresse/etiologia , Incontinência Urinária por Estresse/radioterapia , Ereção Peniana , Inquéritos e Questionários , Reprodutibilidade dos Testes , Estudos Retrospectivos , Seguimentos , Resultado do Tratamento , Estatísticas não Paramétricas , Intervalo Livre de Doença , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade
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