Artificial urinary sphincter AMS 800 for urinary incontinence after radical prostatectomy: the French experience.
Post-radical prostatectomy urinary incontinence (PRP-UI) has a major negative impact on the patient's quality of life with the incidence accounting for over 30% on a patient questionnaire basis. In 1995 the French Urological Association started a prospective survey to investigate the efficacy and safety of the AMS 800 artificial urinary sphincter (AUS) in PRP-UI, and preliminary results are presented for the 103 men enrolled in the study in whom bulbar urethral cuff placement was used exclusively. Surgical revision was necessary in 22 patients (21%). Infection and erosion accounted for 12 non-mechanical revisions leading to complete removal of 6 AUS and to eventual replacement of 6 devices with new ones. Mechanical malfunction accounted for revision in l0 patients (9.7%). Fifty-nine patients (61.45%) reported no leakage for the 96 working devices. Twenty-seven patients (28%) wore no pads, 3 patients used 1 pad and 4 patients used 2 pads/day, and all these patients reported improvement, with only 3 patients (3%) having had more than 2 pads/day. Currently, no non-prosthetic procedure reliably affords such good objective results. Insertion of the AMS 800 AUS no doubt represents an attractive treatment modality available for male urinary incontinence following radical prostatectomy.
Mottet
N
N
Service d'Urologie, Hôpital Gaston Doumergue, Nîmes, France. mottet@zeus.sc.univ-montpl.fr
Boyer
C
C
Chartier-Kastler
E
E
Ben Naoum
K
K
Richard
F
F
Costa
P
P
D005602:France; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D011788:Quality of Life; D012086:Reoperation; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology* / Q000601:surgery*; D016741:Urinary Sphincter, Artificial; D013521:Urologic Surgical Procedures, Male / Q000295:instrumentation / Q000379:methods