Risk Factors for Revision After Artificial Urinary Sphincter Implantation in Male Patients With Stress Urinary Incontinence: A 10-Year Retrospective Study
Purpose To evaluate the preoperative and intraoperative risk factors for revision after artificial urinary sphincter (AUS) implantation in male patients with stress urinary incontinence (SUI). Methods A retrospective analysis from a prospectively maintained database was performed. Male patients, wit...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Continence Society
2022-06-01
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| Series: | International Neurourology Journal |
| Subjects: | |
| Online Access: | http://einj.org/upload/pdf/inj-2142122-061.pdf |
| _version_ | 1811325883681603584 |
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| author | Celeste Manfredi Pramod Krishnappa Esaú Fernández-Pascual Elena García Criado Diego Rengifo David Vázquez Alba Joaquín Carballido Davide Arcaniolo Juan Ignacio Martínez-Salamanca |
| author_facet | Celeste Manfredi Pramod Krishnappa Esaú Fernández-Pascual Elena García Criado Diego Rengifo David Vázquez Alba Joaquín Carballido Davide Arcaniolo Juan Ignacio Martínez-Salamanca |
| author_sort | Celeste Manfredi |
| collection | DOAJ |
| description | Purpose To evaluate the preoperative and intraoperative risk factors for revision after artificial urinary sphincter (AUS) implantation in male patients with stress urinary incontinence (SUI). Methods A retrospective analysis from a prospectively maintained database was performed. Male patients, with moderate-tosevere SUI, undergoing AUS implantation were included. All patients underwent placement of AMS 800. Cause of revision, type of revision, and time to revision were recorded. Multivariable analyzes were performed using a logistic regression to investigate the risk factors. Competing risk analysis according to Fine-Gray model was used to study time to event data. Results A total of 70 patients were included. Revision surgery was performed in 22 of 70 patients (31.4%), after a median (interquartile range) time of 26.5 months (6.5–39.3 months). Overall, 19 of 22 repairs (86.4%) and 3 of 22 explants (13.6%) were recorded. Mechanical dysfunction, urethral erosion, urethral atrophy, and device infection were the causes of revision in 11 of 22 (50.0%), 6 of 22 (27.3%), 3 of 22 (13.6%), and 2 of 22 patients (9.1%). Vesicourethral anastomosis stenosis (P=0.02), urethral cuff size of 3.5 cm (P=0.029), and dual implantation (P=0.048) were independent predictors for revision. Vesicourethral anastomosis stenosis (P=0.01) and urethral cuff size of 3.5 cm (P=0.029) predicted a lower survival of the AUS. Conclusions The vesicourethral anastomosis stenosis, urethral cuff size of 3.5 cm, and dual implantation are independent predictors for revision after AUS implantation. However, only the vesicourethral anastomosis stenosis and urethral cuff size of 3.5 cm predict a lower survival of AUS. |
| first_indexed | 2024-04-13T14:41:19Z |
| format | Article |
| id | doaj.art-2ac0dc565da147d99cf6b185241a8b3d |
| institution | Directory Open Access Journal |
| issn | 2093-4777 2093-6931 |
| language | English |
| last_indexed | 2024-04-13T14:41:19Z |
| publishDate | 2022-06-01 |
| publisher | Korean Continence Society |
| record_format | Article |
| series | International Neurourology Journal |
| spelling | doaj.art-2ac0dc565da147d99cf6b185241a8b3d2022-12-22T02:42:53ZengKorean Continence SocietyInternational Neurourology Journal2093-47772093-69312022-06-0126216116810.5213/inj.2142122.061985Risk Factors for Revision After Artificial Urinary Sphincter Implantation in Male Patients With Stress Urinary Incontinence: A 10-Year Retrospective StudyCeleste Manfredi0Pramod Krishnappa1Esaú Fernández-Pascual2Elena García Criado3Diego Rengifo4David Vázquez Alba5Joaquín Carballido6Davide Arcaniolo7Juan Ignacio Martínez-Salamanca8 Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy Andrology Division, Department of Urology, NU Hospitals, Bangalore, India Department of Urology, Hospital Universitario La Paz, Madrid, Spain Department of Urology, Hospital Universitario Puerta De Hierro-Majadahonda, Madrid, Spain Department of Urology, Hospital Universitario Puerta De Hierro-Majadahonda, Madrid, Spain Department of Urology, Hospital Universitario Puerta De Hierro-Majadahonda, Madrid, Spain Department of Urology, Hospital Universitario Puerta De Hierro-Majadahonda, Madrid, Spain Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy LYX Institute of Urology, Universidad Francisco de Vitoria, Madrid, SpainPurpose To evaluate the preoperative and intraoperative risk factors for revision after artificial urinary sphincter (AUS) implantation in male patients with stress urinary incontinence (SUI). Methods A retrospective analysis from a prospectively maintained database was performed. Male patients, with moderate-tosevere SUI, undergoing AUS implantation were included. All patients underwent placement of AMS 800. Cause of revision, type of revision, and time to revision were recorded. Multivariable analyzes were performed using a logistic regression to investigate the risk factors. Competing risk analysis according to Fine-Gray model was used to study time to event data. Results A total of 70 patients were included. Revision surgery was performed in 22 of 70 patients (31.4%), after a median (interquartile range) time of 26.5 months (6.5–39.3 months). Overall, 19 of 22 repairs (86.4%) and 3 of 22 explants (13.6%) were recorded. Mechanical dysfunction, urethral erosion, urethral atrophy, and device infection were the causes of revision in 11 of 22 (50.0%), 6 of 22 (27.3%), 3 of 22 (13.6%), and 2 of 22 patients (9.1%). Vesicourethral anastomosis stenosis (P=0.02), urethral cuff size of 3.5 cm (P=0.029), and dual implantation (P=0.048) were independent predictors for revision. Vesicourethral anastomosis stenosis (P=0.01) and urethral cuff size of 3.5 cm (P=0.029) predicted a lower survival of the AUS. Conclusions The vesicourethral anastomosis stenosis, urethral cuff size of 3.5 cm, and dual implantation are independent predictors for revision after AUS implantation. However, only the vesicourethral anastomosis stenosis and urethral cuff size of 3.5 cm predict a lower survival of AUS.http://einj.org/upload/pdf/inj-2142122-061.pdfartificial urinary sphinctersrevisionreoperationurinary incontinence |
| spellingShingle | Celeste Manfredi Pramod Krishnappa Esaú Fernández-Pascual Elena García Criado Diego Rengifo David Vázquez Alba Joaquín Carballido Davide Arcaniolo Juan Ignacio Martínez-Salamanca Risk Factors for Revision After Artificial Urinary Sphincter Implantation in Male Patients With Stress Urinary Incontinence: A 10-Year Retrospective Study International Neurourology Journal artificial urinary sphincters revision reoperation urinary incontinence |
| title | Risk Factors for Revision After Artificial Urinary Sphincter Implantation in Male Patients With Stress Urinary Incontinence: A 10-Year Retrospective Study |
| title_full | Risk Factors for Revision After Artificial Urinary Sphincter Implantation in Male Patients With Stress Urinary Incontinence: A 10-Year Retrospective Study |
| title_fullStr | Risk Factors for Revision After Artificial Urinary Sphincter Implantation in Male Patients With Stress Urinary Incontinence: A 10-Year Retrospective Study |
| title_full_unstemmed | Risk Factors for Revision After Artificial Urinary Sphincter Implantation in Male Patients With Stress Urinary Incontinence: A 10-Year Retrospective Study |
| title_short | Risk Factors for Revision After Artificial Urinary Sphincter Implantation in Male Patients With Stress Urinary Incontinence: A 10-Year Retrospective Study |
| title_sort | risk factors for revision after artificial urinary sphincter implantation in male patients with stress urinary incontinence a 10 year retrospective study |
| topic | artificial urinary sphincters revision reoperation urinary incontinence |
| url | http://einj.org/upload/pdf/inj-2142122-061.pdf |
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