Portal de Periódicos da CAPES

ARTIFICIAL URINARY SPHINCTER FOR POST-PROSTATECTOMY INCONTINENCE IN MEN WHO HAD PRIOR RADIOTHERAPY: A RISK AND OUTCOME ANALYSIS

2002; Lippincott Williams & Wilkins; Volume: 167; Issue: 2 Part 1 Linguagem: Inglês

10.1016/s0022-5347(01)69091-8

1527-3792

Mohamed A. Gomha, Timothy B. Boone,

Urological Disorders and Treatments

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Feb 2002ARTIFICIAL URINARY SPHINCTER FOR POST-PROSTATECTOMY INCONTINENCE IN MEN WHO HAD PRIOR RADIOTHERAPY: A RISK AND OUTCOME ANALYSIS MOHAMED A. GOMHA and TIMOTHY B. BOONE MOHAMED A. GOMHAMOHAMED A. GOMHA and TIMOTHY B. BOONETIMOTHY B. BOONE View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)69091-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We retrospectively reviewed our experience with the artificial urinary sphincter for post-prostatectomy incontinence, comparing the outcome of those patients who did and did not receive previous radiation therapy. Materials and Methods: A total of 86 patients with post-prostatectomy incontinence treated with implantation of artificial urinary sphincter includes 58 who did not (group 1) and 28 who did (group 2) receive prior radiation therapy during treatment of prostate carcinoma. In group 2 radiation was the primary treatment followed by salvage prostatectomy in 5 patients, adjuvant after radical retropubic prostatectomy 20 and after transurethral prostatic resection 3. Mean patient age plus or minus standard deviation was 68.3 ± 6.6, and 69.7 ± 6.6 years in groups 1 and 2, respectively. Activation of the sphincter was 4 weeks from the date of surgery, and deactivation at night was not adopted in either group. Patients were followed for a mean period of 31 ± 23, and 36 ± 21 months in groups 1 and 2, respectively. Comparison of continence, urodynamic testing, complication rate, overall satisfaction and quality of life was done between both groups. Results: Reoperation was required in 13 (22.4%) patients in group 1 and 7 (25%) group 2 (p >0.05). Urethral atrophy and/or inadequate compression was seen in 8 (14%) and 4 (14%) patients, and urethral erosion was observed in 1 (2%) and 2 (7%) in groups 1 and 2, respectively (p >0.5). Infection of the device was observed in 4 (7%) patients in group 1 but none group 2 (p >0.05). Continence status was similar in both groups, with 60% and 64% of patients who wore 0 to 1 pad daily in groups 1 and 2, respectively (p >0.05). Urgency with or without urge incontinence was reported after implantation of artificial urinary sphincter in 47%, and 44% of patients in groups 1 and 2, respectively (p >0.05). On a visual analog scale (range 0 to 5, 0—not satisfied at all, 5—extremely satisfied) for satisfaction with the results of the artificial urinary sphincter 86% and 91% of patients reported 4 or greater in groups 1 and 2, respectively (p >0.05). Conclusions: The artificial urinary sphincter has a similar outcome in patients with post-prostatectomy incontinence whether or not they have received previous radiation therapy. No special precaution needs to be adopted for the men in group 2 with post-prostatectomy incontinence considering implantation of artificial urinary sphincter. References 1 : Management of urinary incontinence after prostatectomy with the artificial urinary sphincter. J Urol1989; 142: 302. Link, Google Scholar 2 : Successful outcome of artificial urinary sphincters in men with post-prostatectomy urinary incontinence despite adverse implantation features. J Urol1992; 148: 1166. Link, Google Scholar 3 : Artificial urinary sphincter in patients following major pelvic surgery and/or radiotherapy: are they less favorable candidates?. J Urol1995; 153: 1188. Link, Google Scholar 4 : Experiences with the artificial urinary sphincter in the irradiated patient. J Urol1992; 147: 612. Link, Google Scholar 5 : Mayo Clinic long-term analysis of the functional durability of the AMS 800 artificial urinary sphincter: a review of 323 cases. J Urol1998; 159: 1206. Link, Google Scholar 6 : Mayo Clinic experience with use of the AMS800 artificial urinary sphincter for urinary incontinence following radical prostatectomy. J Urol1989; 142: 1459. Link, Google Scholar 7 : Post-prostatectomy incontinence and the artificial urinary sphincter: a long-term study of patient satisfaction and criteria for success. J Urol1996; 156: 1975. Link, Google Scholar 8 : Artificial sphincter insertion after radiotherapy: is it worthwhile?. BJU Int2000; 85: 490. Google Scholar 9 : Role of urethral reconstruction and artificial sphincter in complicated salvage radical prostatectomy. Urology1988; 32: 304. Google Scholar 10 : Post-operative risk factors associated with artificial urinary sphincter infection-erosion. Br J Urol1995; 75: 354. Google Scholar 11 : Radical prostatectomy incontinence and the AS791 artificial urinary sphincter. J Urol1983; 129: 528. Link, Google Scholar 12 : Artificial sphincters. Br J Urol1991; 67: 225. Google Scholar From the Department of Urology, Mansoura, Egypt, and Scott Department of Urology, Baylor College of Medicine, Houston, Texas© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byYafi F, DeLay K, Stewart C, Chiang J, Sangkum P and Hellstrom W (2016) Device Survival after Primary Implantation of an Artificial Urinary Sphincter for Male Stress Urinary IncontinenceJournal of Urology, VOL. 197, NO. 3 Part 1, (759-765), Online publication date: 1-Mar-2017.Viers B, Linder B, Rivera M, Rangel L, Ziegelmann M and Elliott D (2018) Long-Term Quality of Life and Functional Outcomes among Primary and Secondary Artificial Urinary Sphincter Implantations in Men with Stress Urinary IncontinenceJournal of Urology, VOL. 196, NO. 3, (838-843), Online publication date: 1-Sep-2016.Simhan J, Morey A, Singla N, Tausch T, Scott J, Lemack G and Roehrborn C (2018) 3.5 cm Artificial Urinary Sphincter Cuff Erosion Occurs Predominantly in Irradiated PatientsJournal of Urology, VOL. 193, NO. 2, (593-597), Online publication date: 1-Feb-2015.McGeady J, McAninch J, Truesdale M, Blaschko S, Kenfield S and Breyer B (2018) Artificial Urinary Sphincter Placement in Compromised Urethras and Survival: A Comparison of Virgin, Radiated and Reoperative CasesJournal of Urology, VOL. 192, NO. 6, (1756-1761), Online publication date: 1-Dec-2014.Rouprêt M, Misraï V, Gosseine P, Bart S, Cour F and Chartier-Kastler E (2018) Management of Stress Urinary Incontinence Following Prostate Surgery With Minimally Invasive Adjustable Continence Balloon Implants: Functional Results From a Single Center Prospective StudyJournal of Urology, VOL. 186, NO. 1, (198-203), Online publication date: 1-Jul-2011.Hudak S and Morey A (2018) Impact of 3.5 cm Artificial Urinary Sphincter Cuff on Primary and Revision Surgery for Male Stress Urinary IncontinenceJournal of Urology, VOL. 186, NO. 5, (1962-1966), Online publication date: 1-Nov-2011.Lai H, Hsu E, Teh B, Butler E and Boone T (2018) 13 Years of Experience With Artificial Urinary Sphincter Implantation at Baylor College of MedicineJournal of Urology, VOL. 177, NO. 3, (1021-1025), Online publication date: 1-Mar-2007.Petero V and Diokno A (2018) Comparison of the Long-Term Outcomes Between Incontinent Men and Women Treated With Artificial Urinary SphincterJournal of Urology, VOL. 175, NO. 2, (605-609), Online publication date: 1-Feb-2006.Raj G, Peterson A and Webster G (2018) Outcomes Following Erosions of the Artificial Urinary SphincterJournal of Urology, VOL. 175, NO. 6, (2186-2190), Online publication date: 1-Jun-2006.DALKIN B, WESSELLS H and CUI H (2018) A National Survey Of Urinary And Health Related Quality Of Life Outcomes In Men With An Artificial Urinary Sphincter For Post-Radical Prostatectomy IncontinenceJournal of Urology, VOL. 169, NO. 1, (237-239), Online publication date: 1-Jan-2003.GOMHA M and BOONE T (2018) Voiding Patterns In Patients With Post-Prostatectomy Incontinence: Urodynamic And Demographic AnalysisJournal of Urology, VOL. 169, NO. 5, (1766-1769), Online publication date: 1-May-2003. Volume 167Issue 2 Part 1February 2002Page: 591-596 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsurinary incontinenceprostatectomyradiotherapyurinary sphincter, artificialMetricsAuthor Information MOHAMED A. GOMHA More articles by this author TIMOTHY B. BOONE Financial interest and/or other relationship with American Medical Systems. More articles by this author Expand All Advertisement PDF downloadLoading ...