Pd39-03 Outcomes Associated With Dual Artificial Urinary Sphincter and Inflatable Penile Prostheses: Analysis of a Contemporary, New York Statewide Cohort
Year: 2018
Type: article
Study design: Observational Study
Abstract: INTRODUCTION AND OBJECTIVES: To evaluate the perioperative and long-term functional outcomes of bladder neck and peribulbar cuff placement of an artificial urinary sphincter (AUS) in a population of adult male patients with spinal dysraphism.METHODS: A retrospective analysis of the French spina bifida (SB) network database was performed.Patients who underwent implantation of an AUS from January 1985 to November 2015 were selected and stratified into two groups according to cuff location: bladder neck vs. bulbar urethra.Explantation-free and revision-free device survivals were estimated using the Kaplan-Meier method and compared using the log rank test.Cox regression models were used to assess prognostic factors of AUS device failure.RESULTS: Sixty-five patients were included.Most patients were not wheelchair-bound.The cuff was implanted around the bulbar urethra in 46 procedures (59%) and around the bladder neck in 32 procedures (41%).Median revision-free device survivals were 11.7 and 14.3 years (p¼0.73)and median explantation-free device survivals were 18.5 and 24.5 years (p¼0.08) in peribulbar and bladder neck groups respectively.In multivariate analysis, clean-intermittent catheterization was the only predictor of AUS device failure (no influence of cuff location).At the last follow-up, satisfactory continence was similar in both groups (83% vs. 75%, p¼0.75).CONCLUSIONS: In SB male patients, the morbidity and functional outcomes were similar between bladder neck and bulbar urethra cuff placement but with a trend towards a longer survival without explantation in the bladder neck group.Clean-intermittent catheterization was the only predictor of shorter device survival in multivariate analysis.
Source: The Journal of Urology
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2795752806