Efficacy and Safety of Artificial Urinary Sphincter for Stress Urinary Incontinence after Prostate Surgery

ABSTRACT

PURPOSE: To evaluate the efficacy and safety of artificial urinary sphincter (AUS) for the treatment of stress urinary incontinence (UI) after prostate surgery. MATERIALS AND METHODS: We performed a retrospective chart review of 19 patients who underwent AUS implantation from July 2003 to November 2008. Efficacy was evaluated in terms of the postoperative changes in daily pad use, incontinence visual analogue scale (I-VAS), International Continence Society male-Short Form questionnaire (ICS-male SF), Incontinence Quality of Life questionnaire (I-QoL), and patients' satisfaction postoperatively. No pad use was defined as cure, and use of 1 pad or fewer per day as improvement. Cure and improvement were regarded as success. Complications and durability of the AUS were evaluated. RESULTS: The median age of the patients was 70.0 years (range, 47-76 years). With a median follow-up period of 11.8 months (range, 6.2-48.1 months), the success rate was 68.4% (13/19; cure in 12 and improvement in 1). I-VAS, subscale scores of ICS-male SF (incontinence and QoL), and total and subscale scores of I-QoL (psychosocial impact, social embarrassment, avoidance, and limiting behaviors) were significantly improved. Fifteen (78.9%) patients reported being satisfied. Six (31.5%) patients required revision volume adjustment for 2, second cuff implantation for 2, pump reposition for 1, and pump reposition, volume adjustment, and second cuff implantation for 1. One of the patients who had a second cuff implantation had the sphincter explanted for infection. CONCLUSIONS: Despite the high rate of revision, the satisfaction rate was high and the quality of life was significantly improved after AUS implantation for urinary incontinence after prostate surgery.