Continence and quality of life assessment after artificial urinary sphincter implantation.
BACKGROUND
Sphincter-related incontinence after radical prostatectomy, benign prostatectomy or due to neurogenic disease has a considerable negative impact on quality of life. Artificial urinary sphincter implantation is a mainstay therapeutic option for these patients.


OBJECTIVE
To assess patient satisfaction, subjective long-term continence and complications after AMS 800 artificial urinary sphincter implantation.


METHODS
The medical records of 34 patients who underwent artificial urinary sphincter implantation for radical prostatectomy (n = 23), simple prostatectomy (n = 9) or neurogenic disease (n = 2) between 1995 and 2003 were studied retrospectively. Median follow-up was 49 months (range 3-102 months). Records were analyzed for urinary sphincter survival and complications. Quality of life and continence assessment was done by mailing an impact questionnaire.


RESULTS
In 4 of the 34 patients (11.7%) the device was removed due to infection. One of the four had surgical revision elsewhere, and the other three were not interested in re-implantation of the device. Two patients (5.9%) underwent revisions due to mechanical failure. One patient died and three patients were not located. Twenty-seven out of a possible 30 patients (88%) completed the questionnaire; 22 (85%) achieved social continence (0-2 pads daily), and one patient had subjective difficulty activating the device. Subjective improvement and patient satisfaction was rated as 4.22 and 4.11, respectively (scale 0 to 5).


CONCLUSIONS
Artificial urinary sphincter implantation is an efficacious option for sphincter-related incontinence. This study documents the positive impact of artificial urinary sphincter implantation on quality of life with acceptable complications; these results are comparable to other published studies.
Gnessin
Ehud
E
Institute of Urology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel. ehudgn@netvision.net.il
Livne
Pinhas M
PM
Baniel
Jack
J
Gillon
Gabriel
G
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011468:Prostatectomy / Q000009:adverse effects*; D011469:Prostatic Diseases / Q000601:surgery; D019919:Prosthesis Implantation / Q000295:instrumentation*; D011788:Quality of Life; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*; D016741:Urinary Sphincter, Artificial