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
2009; Lippincott Williams & Wilkins; Volume: 182; Issue: 5 Linguagem: Inglês
10.1016/j.juro.2009.07.068
ISSN1527-3792
AutoresGerard D. Henry, Stephen M. Graham, Robert J. Cornell, Mario A. Cleves, Caroline J. Simmons, Ioannis Vakalopoulos, Brian J. Flynn,
Tópico(s)Urological Disorders and Treatments
ResumoNo AccessJournal of UrologyAdult Urology1 Nov 2009A Multicenter Study on the Perineal Versus Penoscrotal Approach for Implantation of an Artificial Urinary Sphincter: Cuff Size and Control of Male Stress Urinary Incontinence Gerard D. Henry, Stephen M. Graham, Robert J. Cornell, Mario A. Cleves, Caroline J. Simmons, Ioannis Vakalopoulos, and Brian Flynn Gerard D. HenryGerard D. Henry Regional Urology, Shreveport, Louisiana , Stephen M. GrahamStephen M. Graham Division of Urology, University of Kansas, Kansas City, Kansas , Robert J. CornellRobert J. Cornell Cornell Urology, Houston, Texas , Mario A. ClevesMario A. Cleves Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas , Caroline J. SimmonsCaroline J. Simmons Regional Urology, Shreveport, Louisiana , Ioannis VakalopoulosIoannis Vakalopoulos Department of Urology, Aristotle University of Thessaloniki, Greece , and Brian FlynnBrian Flynn Division of Urology, Department of Surgery, University of Colorado, Denver, Colorado View All Author Informationhttps://doi.org/10.1016/j.juro.2009.07.068AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: In a single center retrospective study we previously reported superior dry rates and fewer artificial urinary sphincter revisions when the sphincter cuff was placed via the traditional perineal approach compared with a penoscrotal approach. A multicenter study was performed to compare the approaches further and explain the disparity in outcomes. Materials and Methods: We performed a retrospective review of 158 patients who underwent these procedures from April 1987 to October 2007 at 4 centers. Results: During 184 surgeries in 158 patients 201 artificial urinary sphincter cuffs were placed (90 penoscrotal and 111 perineal). Among patients with known followup the completely dry rate for single cuff artificial urinary sphincters was 17 of 62 (27.4%) in the penoscrotal group and 41 of 93 (44.1%) in the perineal group (p = 0.04). Continued incontinence necessitated subsequent tandem cuff in 7 of the 62 (11.3%) penoscrotal cases compared to only 5 of the 93 (5.4%) perineal cases. Cuff size in the penoscrotal group was 5.0 cm in 1 patient (1.1%), 4.5 cm in 11 (12.2%) and 4.0 cm in 78 (86.7%). Cuff size in the perineal group was 5.5 cm in 1 patient (0.9%), 5.0 cm in 8 (7.2%), 4.5 cm in 30 (27.0%) and 4.0 cm in 72 (64.9%). Conclusions: There appears to be a higher completely dry rate with fewer subsequent tandem cuff additions with the perineal approach compared to the penoscrotal approach. 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Google Scholar © 2009 by American Urological AssociationFiguresReferencesRelatedDetailsCited byBentellis I, El-Akri M, Cornu J, Brierre T, Cousin T, Gaillard V, Dupuis H, Tricard T, Hermieu N, Bertrand-Leon P, Chevallier D, Bruyere F, Biardeau X, Hermieu J, Lecoanet P, Capon G, Game X, Saussine C, Durand M and Peyronnet B (2021) Prevalence and Risk Factors of Artificial Urinary Sphincter Revision in Nonneurological Male PatientsJournal of Urology, VOL. 206, NO. 5, (1248-1257), Online publication date: 1-Nov-2021.Sandhu J, Breyer B, Comiter C, Eastham J, Gomez C, Kirages D, Kittle C, Lucioni A, Nitti V, Stoffel J, Westney O, Murad M and McCammon K (2019) Incontinence after Prostate Treatment: AUA/SUFU GuidelineJournal of Urology, VOL. 202, NO. 2, (369-378), Online publication date: 1-Aug-2019.Moser D, Kaufman M, Milam D, Johnsen N, Cleves M, Broghammer J, Brant W, Jones L, Brady J, Gross M, Jani K and Henry G (2018) Impact of Radiation and Transcorporeal Artificial Sphincter Placement in Patients with Prior Urethral Cuff Erosion: Results from a Retrospective Multicenter AnalysisJournal of Urology, VOL. 200, NO. 6, (1338-1343), Online publication date: 1-Dec-2018.Kaiho Y, Masuda H, Takei M, Hirayama T, Mitsui T, Yokoyama M, Kitta T, Kawamorita N, Nakagawa H, Iwamura M and Arai Y (2017) Surgical and Patient Reported Outcomes of Artificial Urinary Sphincter Implantation: A Multicenter, Prospective, Observational StudyJournal of Urology, VOL. 199, NO. 1, (245-250), Online publication date: 1-Jan-2018.Yafi 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.Segal R, Cabrini M, Harris E, Mostwin J, Bivalacqua T and Burnett A (2013) Combined Inflatable Penile Prosthesis-Artificial Urinary Sphincter Implantation: No Increased Risk of Adverse Events Compared to Single or Staged Device ImplantationJournal of Urology, VOL. 190, NO. 6, (2183-2188), Online publication date: 1-Dec-2013.Anusionwu I, Miles-Thomas J, Hernandez D and Wright E (2012) Anatomical and Manometric Comparison of Perineal and Transscrotal Approaches to Artificial Urinary Sphincter PlacementJournal of Urology, VOL. 188, NO. 5, (1834-1836), Online publication date: 1-Nov-2012. Volume 182Issue 5November 2009Page: 2404-2409 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordsurinary sphinctermalegenitaliaurinary incontinenceurethraartificialMetricsAuthor Information Gerard D. Henry Regional Urology, Shreveport, Louisiana Financial interest and/or other relationship with AMS, Coloplast, Pfizer, Lilly and Astellas. More articles by this author Stephen M. Graham Division of Urology, University of Kansas, Kansas City, Kansas Nothing to disclose. More articles by this author Robert J. Cornell Cornell Urology, Houston, Texas Nothing to disclose. More articles by this author Mario A. Cleves Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas Nothing to disclose. More articles by this author Caroline J. Simmons Regional Urology, Shreveport, Louisiana Nothing to disclose. More articles by this author Ioannis Vakalopoulos Department of Urology, Aristotle University of Thessaloniki, Greece Nothing to disclose. More articles by this author Brian Flynn Division of Urology, Department of Surgery, University of Colorado, Denver, Colorado Financial interest and/or other relationship with Ethicon Women's Health & Urology, Swan Valley Medical and Astellas. More articles by this author Expand All Advertisement PDF downloadLoading ...
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