The impact of perioperative complications on favorable outcomes after artificial urinary sphincter implantation for post-prostatectomy incontinence
Int. braz. j. urol
;
46(4): 632-639, 2020. tab
Article
in English
| LILACS
| ID: biblio-1134196
ABSTRACT
ABSTRACT Objective To investigate the effect of perioperative complications involving artificial urinary sphincter (AUS) implantation on rates of explantation and continence as well as health-related quality of life (HRQOL). Materials and methods Inclusion criteria encompassed non-neurogenic, moderate-to-severe stress urinary incontinence (SUI) post radical prostatectomy and primary implantation of an AUS performed by a high-volume surgeon (>100 previous implantations). Reporting complications followed the validated Clavien-Dindo scale and Martin criteria. HRQOL was assessed by the validated IQOL score, continence by the validated ICIQ-SF score. Statistical analysis included Chi (2) test, Mann-Whitney-U test, and multivariate regression models (p <0.05). Results 105 patients from 5 centers met the inclusion criteria. After a median follow-up of 38 months, explantation rates were 27.6% with a continence rate of 48.4%. In the age-adjusted multivariate analysis, perioperative urinary tract infection was confirmed as an independent predictor of postoperative explantation rates [OR 24.28, 95% CI 2.81-209.77, p=0.004). Salvage implantation (OR 0.114, 95% CI 0.02-0.67, p=0.016) and non-prostatectomy related incontinence (OR 0.104, 95% CI 0.02-0.74, p=0.023) were independent predictors for worse continence outcomes. Low visual analogue scale scores (OR 9.999, 95% CI 1,42-70.25, p=0.021) and ICIQ-SF scores, respectively (OR 0.674, 95% CI 0.51-0.88, p=0.004) were independent predictors for increased HRQOL outcomes. Perioperative complications did not significantly impact on continence and HRQOL outcomes. Conclusion Findings show postoperative infections adversely affect device survival after AUS implantation. However, if explantation can be avoided, the comparative long-term functional results and HRQOL outcomes are similar between patients with or without perioperative complications.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Urinary Incontinence, Stress
/
Urinary Sphincter, Artificial
Type of study:
Prognostic study
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2020
Type:
Article
Affiliation country:
Germany
/
United kingdom
Institution/Affiliation country:
Diakonie Hospital Schwäbisch Hall/DE
/
Helios Hospital Duisburg/DE
/
Johannes-Gutenberg University/DE
/
Ludwig-Maximilians-University/DE
/
Marienhausklinikum Bendorf-Neuwied-Waldbreitbach/DE
/
NHS Foundation Trust/GB
/
University Hospital Bonn/DE
/
University Hospital Heidelberg/DE
/
University Hospital Muenster/DE
/
Vivantes Hospital Berlin/DE
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