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Prevalence and Risk Factors of Artificial Urinary Sphincter Revision in Nonneurological Male Patients

2021; Lippincott Williams & Wilkins; Volume: 206; Issue: 5 Linguagem: Inglês

10.1097/ju.0000000000001954

1527-3792

Imad Bentellis, M. El-Akri, Jean‐Nicolas Cornu, T. Brierre, Tiffany Cousin, Victor Gaillard, H. Dupuis, Thibault Tricard, Nicolas Hermieu, Priscilla Bertrand-Leon, D. Chevallier, F. Bruyère, Xavier Biardeau, Jean‐François Hermieu, Pierre Lecoanet, G. Capon, X. Gamé, C. Saussine, M. Durand, B. Peyronnet,

Ureteral procedures and complications

No AccessJournal of UrologyAdult Urology1 Nov 2021Prevalence and Risk Factors of Artificial Urinary Sphincter Revision in Nonneurological Male PatientsThis article is commented on by the following:Editorial CommentEditorial Comment Imad Bentellis, Mehdi El-Akri, Jean-Nicolas Cornu, Thibaut Brierre, Tiffany Cousin, Victor Gaillard, Hugo Dupuis, Thibault Tricard, Nicolas Hermieu, Priscilla Bertrand-Leon, Daniel Chevallier, Franck Bruyere, Xavier Biardeau, Jean-Francois Hermieu, Pierre Lecoanet, Grégoire Capon, Xavier Game, Christian Saussine, Matthieu Durand, and Benoit Peyronnet Imad BentellisImad Bentellis *Correspondence: Urology Department, University Hospital of Nice, 30 voie romaine06000Nice , France telephone: +33651818551; E-mail Address: [email protected] http://orcid.org/0000-0003-0200-6409 Department of Urology, University of Nice, Nice, France , Mehdi El-AkriMehdi El-Akri Department of Urology, University of Rennes, Rennes, France , Jean-Nicolas CornuJean-Nicolas Cornu Department of Urology, University of Rouen, Rouen, France , Thibaut BrierreThibaut Brierre Department of Urology, University of Toulouse, Toulouse, France , Tiffany CousinTiffany Cousin Department of Urology, University of Bordeaux, Bordeaux, France , Victor GaillardVictor Gaillard Department of Urology, University of Strasbourg, Strasbourg, France , Hugo DupuisHugo Dupuis Department of Urology, University of Rouen, Rouen, France , Thibault TricardThibault Tricard Department of Urology, University of Strasbourg, Strasbourg, France , Nicolas HermieuNicolas Hermieu Department of Urology, Bichat Hospital, Paris, France , Priscilla Bertrand-LeonPriscilla Bertrand-Leon Department of Urology, University of Reims, Reims, France , Daniel ChevallierDaniel Chevallier Department of Urology, University of Nice, Nice, France , Franck BruyereFranck Bruyere Department of Urology, University of Tours, Tours, France , Xavier BiardeauXavier Biardeau Department of Urology, University of Lille, Lille, France , Jean-Francois HermieuJean-Francois Hermieu Department of Urology, Bichat Hospital, Paris, France , Pierre LecoanetPierre Lecoanet Department of Urology, University of Nancy, Nancy, France , Grégoire CaponGrégoire Capon Department of Urology, University of Bordeaux, Bordeaux, France , Xavier GameXavier Game Department of Urology, University of Toulouse, Toulouse, France , Christian SaussineChristian Saussine Department of Urology, University of Strasbourg, Strasbourg, France , Matthieu DurandMatthieu Durand INSERM U1081 - CNRS UMR 7284 Université Côte d'Azur, France , and Benoit PeyronnetBenoit Peyronnet Department of Urology, University of Rennes, Rennes, France View All Author Informationhttps://doi.org/10.1097/JU.0000000000001954AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The main objective of this study was to assess the prevalence and risk factors of male artificial urinary sphincter (AUS) mechanical failures and nonmechanical failures. Materials and Methods: The charts of all male patients who underwent AUS implantation between 2004 and 2020 in 16 centers were retrospectively reviewed. Patients with neurogenic stress urinary incontinence (SUI) were excluded as well as revisions/explantations due to infections and/or erosions. The causes of revision were divided into mechanical failures (fluid loss or malfunction from any components of the AUS), nonmechanical failures (urethral atrophy, recurrence/persistence of SUI despite normally functioning device) and other (pump malposition, balloon herniation, hematoma, pain). Failure-free survival analysis was performed both for general and specific causes of revision. Predictors of mechanical and nonmechanical failures were determined by Cox proportional hazards model. Results: A total of 1,020 patients met the inclusion criteria. After a median followup of 20 months, the estimated 5-year and 10-year overall revision-free survival was 60% and 40%, respectively. There were 214 AUS revisions: 59 (27.6%) for mechanical failures, 121 (56.5%) for nonmechanical failures and 34 (15.9%) other causes of revision. In multivariable Cox regression analysis, larger cuff size was the only predictor of overall revisions (HR=1.04 [1.01–1.07]; p=0.01) and revision for nonmechanical failure (HR=1.05 [1.02–1.09]; p=0.004). Conclusions: Half of the male AUS patients underwent device revision within the first 10 years after implantation. Nonmechanical failures are the primary cause of AUS revision in nonneurological men. Larger cuff size appears to be the main determinant of AUS revision risk. References 1. : Treatment of urinary incontinence by implantable prosthetic sphincter. Urology 1973; 1: 252. Google Scholar 2. : AUS consensus group, campeau L, corcos J. Artificial urinary sphincter: report of the 2015 consensus conference. Neurourol Urodyn, suppl., 2016; 35: S8. Google Scholar 3. : Contemporary review of artificial urinary sphincters for male stress urinary incontinence. Sex Med Rev 2016; 4: 157. Google Scholar 4. : Impact of radiation and transcorporeal artificial sphincter placement in patients with prior urethral cuff erosion: results from a retrospective multicenter analysis. J Urol 2018; 200: 1338. Link, Google Scholar 5. : Artificial urinary sphincter cuff erosion heat map shows similar anatomical characteristics for transcorporal and standard approach. J Urol 2020; 204: 1027. Link, Google Scholar 6. R Core Team: R. A Language and Environment for Statistical Computing [Internet]. Vienna, Austria: R Foundation for Statistical Computing 2020. Available at https://www.R-project.org/. Google Scholar 7. : Causes of artificial urinary sphincter failure and strategies for surgical revision: implications of device component survival. Eur Urol Focus 2019; 5: 887. Google Scholar 8. : Efficacy and safety of artificial urinary sphincter (AUS): results of a large multi-institutional cohort of patients with mid-term follow-up. Neurourol Urodyn 2019; 38: 710. Google Scholar 9. : Risk factors for subsequent urethral atrophy in patients undergoing artificial urinary sphincter placement. Turk J Urol 2019; 45: 124. Google Scholar 10. : Decreasing need for artificial urinary sphincter revision surgery by precise cuff sizing in men with spongiosal atrophy. J Urol 2014; 192: 798. Link, Google Scholar 11. : Urethral atrophy after implantation of an artificial urinary sphincter: fact or fiction?BJU Int 2016; 117: 669. Google Scholar 12. : Artificial urinary sphincter mechanical failures-is it better to replace the entire device or just the malfunctioning component?J Urol 2016; 195: 1523. Link, Google Scholar 13. : Transcorporal artificial urinary sphincter cuff placement in cases requiring revision for erosion and urethral atrophy. J Urol 2002; 167: 2075. Link, Google Scholar 14. : Difference between urethral circumference and artificial urinary sphincter cuff size, and its effect on postoperative incontinence. J Urol 2014; 191: 138. Link, Google Scholar 15. : Artificial urinary sphincter cuff size predicts outcome in male patients treated for stress incontinence: results of a large central European multicenter cohort study. Int Neurourol J 2019; 23: 219. Google Scholar 16. : Urethral atrophy is now a rare cause for artificial urinary sphincter revision surgery in the contemporary 3.5 cm cuff era. Transl Androl Urol 2020; 9: 50. Google Scholar 17. : Outcomes following artificial sphincter implantation after prior unsuccessful male sling. J Urol 2012; 187: 2149. Link, Google Scholar 18. : Perineal approach for artificial urinary sphincter implantation appears to control male stress incontinence better than the transscrotal approach. J Urol 2008; 179: 1475. Link, Google Scholar 19. : A multicenter study on the perineal versus penoscrotal approach for implantation of an artificial urinary sphincter: cuff size and control of male stress urinary incontinence. J Urol 2009; 182: 2404. Link, Google Scholar 20. : Device survival after primary implantation of an artificial urinary sphincter for male stress urinary incontinence. J Urol 2017; 197: 759. Link, Google Scholar 21. : Risk factors for artificial urinary sphincter failure. World J Urol 2016; 34: 595. Google Scholar 22. : Patterns and timing of artificial urinary sphincter failure. World J Urol 2018; 36: 939. Google Scholar 23. : Complications following artificial urinary sphincter placement after radical prostatectomy and radiotherapy: a meta-analysis. BJU Int 2015; 116: 623. Google Scholar 24. : Temporal trends in adoption of and indications for the artificial urinary sphincter. J Urol 2009; 181: 2622. Link, Google Scholar 25. : Artificial urinary sphincter in male patients with spina bifida: comparison of perioperative and functional outcomes between bulbar urethra and bladder neck cuff placement. J Urol 2018; 199: 791. Link, Google Scholar Conflicts of interest: Benoit Peyronnet, Jean Nicolas Cornu, Xavier Gamé, Franck Bruyère, Gregoire Capon, Xavier Biardeau, Jean Francois Hermieu are consultants for Boston Scientific. Other authors have no conflicts of interest. Compliance with ethical standards: This research involved human participants (IRB No. CNIL2216559). Informed consent from all participants was obtained. Author contributions: Imad BENTELLIS Protocol/project development, data collection or management, Data analysis, Manuscript writing/editing. Mehdi EL-AKRI Protocol/project development, data collection or management. Thibault TRICARD data collection or management. Thibaut BRIERRE data collection or management. Tiffany COUSIN data collection or management. Hugo DUPUIS data collection or management. Nicolas HERMIEU data collection or management. Baptiste POUSSOT data collection or management. Alice PITOUT data collection or management. Priscilla BERTRAND-LEON data collection or management. Daniel CHEVALLIER data collection or management, data collection or management. Franck BRUYERE data collection or management, data collection or management. Christian SAUSSINE data collection or management, data collection or management. Jean Francois HERMIEU data collection or management, data collection or management. Pierre LECOANET data collection or management, data collection or management. Gregoire CAPON data collection or management, data collection or management. Jean-Nicolas CORNU data collection or management, data collection or management. Xavier GAME data collection or management, data collection or management. Matthieu DURAND Data analysis, Manuscript writing/editing. Benoit PEYRONNET Protocol/project development, Data analysis, Manuscript writing/editing. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of Urology12 Aug 2021Editorial CommentJournal of Urology12 Aug 2021Editorial Comment Volume 206Issue 5November 2021Page: 1248-1257 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.Keywordsurodynamicslower urinary tract symptomsreoperationurinary sphincter, artificialurinary incontinence, stressAcknowledgmentsWe thank Luc Corbel, Hervé Monsaint, Baptise Poussot, Alice Pitout, Damien Robin and Florian Beraud for their contribution in data collection and manuscript revision.MetricsAuthor Information Imad Bentellis Department of Urology, University of Nice, Nice, France *Correspondence: Urology Department, University Hospital of Nice, 30 voie romaine06000Nice , France telephone: +33651818551; E-mail Address: [email protected] More articles by this author Mehdi El-Akri Department of Urology, University of Rennes, Rennes, France More articles by this author Jean-Nicolas Cornu Department of Urology, University of Rouen, Rouen, France More articles by this author Thibaut Brierre Department of Urology, University of Toulouse, Toulouse, France More articles by this author Tiffany Cousin Department of Urology, University of Bordeaux, Bordeaux, France More articles by this author Victor Gaillard Department of Urology, University of Strasbourg, Strasbourg, France More articles by this author Hugo Dupuis Department of Urology, University of Rouen, Rouen, France More articles by this author Thibault Tricard Department of Urology, University of Strasbourg, Strasbourg, France More articles by this author Nicolas Hermieu Department of Urology, Bichat Hospital, Paris, France More articles by this author Priscilla Bertrand-Leon Department of Urology, University of Reims, Reims, France More articles by this author Daniel Chevallier Department of Urology, University of Nice, Nice, France More articles by this author Franck Bruyere Department of Urology, University of Tours, Tours, France More articles by this author Xavier Biardeau Department of Urology, University of Lille, Lille, France More articles by this author Jean-Francois Hermieu Department of Urology, Bichat Hospital, Paris, France More articles by this author Pierre Lecoanet Department of Urology, University of Nancy, Nancy, France More articles by this author Grégoire Capon Department of Urology, University of Bordeaux, Bordeaux, France More articles by this author Xavier Game Department of Urology, University of Toulouse, Toulouse, France More articles by this author Christian Saussine Department of Urology, University of Strasbourg, Strasbourg, France More articles by this author Matthieu Durand INSERM U1081 - CNRS UMR 7284 Université Côte d'Azur, France More articles by this author Benoit Peyronnet Department of Urology, University of Rennes, Rennes, France More articles by this author Expand All Conflicts of interest: Benoit Peyronnet, Jean Nicolas Cornu, Xavier Gamé, Franck Bruyère, Gregoire Capon, Xavier Biardeau, Jean Francois Hermieu are consultants for Boston Scientific. Other authors have no conflicts of interest. Compliance with ethical standards: This research involved human participants (IRB No. CNIL2216559). Informed consent from all participants was obtained. Author contributions: Imad BENTELLIS Protocol/project development, data collection or management, Data analysis, Manuscript writing/editing. Mehdi EL-AKRI Protocol/project development, data collection or management. Thibault TRICARD data collection or management. Thibaut BRIERRE data collection or management. Tiffany COUSIN data collection or management. Hugo DUPUIS data collection or management. Nicolas HERMIEU data collection or management. Baptiste POUSSOT data collection or management. Alice PITOUT data collection or management. Priscilla BERTRAND-LEON data collection or management. Daniel CHEVALLIER data collection or management, data collection or management. Franck BRUYERE data collection or management, data collection or management. Christian SAUSSINE data collection or management, data collection or management. Jean Francois HERMIEU data collection or management, data collection or management. Pierre LECOANET data collection or management, data collection or management. Gregoire CAPON data collection or management, data collection or management. Jean-Nicolas CORNU data collection or management, data collection or management. Xavier GAME data collection or management, data collection or management. Matthieu DURAND Data analysis, Manuscript writing/editing. Benoit PEYRONNET Protocol/project development, Data analysis, Manuscript writing/editing. Advertisement PDF downloadLoading ...