Factors affecting the success and complications of artificial urinary sphincter implantation and our long-term outcomes (25 years of experience)

Abstract

Objective: In this study we investigated the factors affecting both our success and complication rates in patients undergone artificial urinary sphincter (AUS) implantation and our long-term results. 

Material and Methods: Data from 82 patients which were performed a total of 97 AUS implantation (including 13 recurrent patients; 2 were performed 3 times and 11 were performed 2 times) in Urology Clinic of Ankara Dıskapı Training and Research Hospital between the years 1990 and 2015 were analyzed retrospectively. Degree and amount of incontinence and quality of life were evaluated by International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI SF), pad test and the 5th question in ICIQ-UI SF, respectively. Mean age of our patients were 66.2 (15-79) years while mean follow-up period was 76 (6-300) months. Two groups were composed as AUS implantation one time and recurrent times and the results were compared. 

Results: Of our AUS implantated patients, we noticed complete dryness in 57 (69.5%), social continence in 15(18.2%) and incontinence in 10 (12.1%). Of the 13 recurrent patients, we noticed complete dryness in 5 (38.4%), social continence in 5 (38.4%) an incontinence in 3 (23.07%). When compared; symptom score, amount of incontinence and quality of life score results seemed to be better in the 1 time AUS performed group than the recurrent group, but it was not statistically significant. Complication rate was 20.7% including infection and/or cuff erosion in 12 patients and mechanical failure in 5 patients. 

Conclusion: AUS is the most effective treatment method of incontinence in appropriate patients. We believe that it may be preferable by considering cost analysis and revision and re-implantation facilities in terms of being a safe and economical procedure. 

Keywords

• Urethra
• Prostatectomy
• Urinary Sphincter
• Artificial

Artifisyel üriner sfinkter implantasyonunun başarı ve komplikasyonunu etkileyen faktörler ve uzun dönem sonuçlarımız (25 yıllık deneyim)

Abstract

Amaç: Artifisyel Üriner Sfinkter (AUS) implantasyonu uyguladığımız olgularda yöntemin başarı ve komplikasyon oranlarını ve bunu etkileyen faktörler ile uzun dönem sonuçlarımızı sunmayı amaçladık. 

Gereç ve Yöntemler:1990 ile 2015 yılları arasında Ankara Dışkapı Eğitim ve Araştırma Hastanesi Üroloji kliniğinde toplam 97AUS implantasyonu uyguladığımız 82 hastanın verileri retrospektif olarak incelendi. 11 hastaya 2 kez ve 2 hastaya 3 kez olmak üzere toplam 13 hastaya rekürren AUS implantasyonu uygulandı. Hastaların inkontinans derecesi International Consultation on Incontinence Questionnaire-Short form (ICIQ-UI SF)’a göre miktarı ise pad testi yapılarak, yaşam kaliteleri ise ICIQ-UI SF’ daki 5. soru ile ayrıca değerlendirilip kaydedildi. Hastalarımızın yaş ortalaması 66.2 (15-79) yıl iken ortalama takip süresi 76 (6-300) ay idi. Bir kez ve rekürren AUS implantasyonu şeklinde 2 grup oluşturularak sonuçları karşılaştırıldı. 

Bulgular: AUS uyguladığımız hastalarımızdan 57’sinde (%69.5) tam kuruluk, 15’inde (%18.2) sosyal kontinans ve 10 (%12.1) tanesinde ise inkontinans oranları saptanmıştır. Rekürren AUS uyguladığımız 13 hastamızın 5’inde (%38.4) tam kuruluk, 5’inde (%38.4) sosyal kontinans, 3’ünde (%23.07) ise kontinansa ulaşılamamıştır. Semptom skorları, inkontinans miktarları ve yaşam kaliteleri karşılaştırıldığında 1 kez AUS uygulanan grupta rekürren uygulanan gruba göre sonuçlar daha iyi gözükse de istatistiksel olarak anlamlı bulunmamıştır. 12 hastada enfeksiyon ve/ veya cuf erozyonu, 5 hastada ise mekanik arıza olmak üzere %20.7 oranında komplikasyon saptanmıştır. 

Keywords

• Üretra
• prostatektomi
• Artifisyel Üriner Sfinkter

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