[AMS 800 artificial urinary sphincter implantation: can the penoscrotal approach constitute an alternative to the perineal approach?].
OBJECTIVE
To compare the short-term results of penoscrotal and perineal artificial urinary sphincter implantation.


METHODS
From May 2005 to February 2007, 37 artificial urinary sphincters were implanted successively, via a penoscrotal approach in 16 cases and via a perineal approach in 21 cases. Incontinence was secondary to prostate surgery (n=36) and pelvic trauma (n=1). Seventeen patients had a history of external beam radiotherapy. The times and modalities of activation of the sphincter were identical in the two groups.


RESULTS
The mean age of the patients, the mean operating time, the mean catheterization duration, the mean hospital stay and the mean postoperative follow-up were equivalent in the two groups. Six urethral erosions (37.5%) and one scrotal erosion due to the pump (6.6%) were observed in the penoscrotal group and infection of the sphincter in two patients (9.5%) and pump migration in another two patients (9.5%), but no urethral erosions were observed in the perineal group. The success rate without revision was 56% in the penoscrotal group and 71.5% in the perineal group.


CONCLUSIONS
The perineal approach is the reference incision, as the penoscrotal approach is associated with a high rate of erosion. The penoscrotal urethral approach can constitute an alternative when the bulbar urethra cannot be used.
Fassi-Fehri
H
H
Service d'urologie et de la transplantation, pavillon V, hôpital Edouard-Herriot, hospices civils de Lyon, place d'Arsonval, 69003 Lyon, France. hakim.fassi-fehri@chu-lyon.fr
Dinia
E M
EM
Genevoix
S
S
Murat
F-J
FJ
Poissonnier
L
L
Badet
L
L
Colombel
M
M
Martin
X
X
Gelet
A
A
D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000379:methods*; D014549:Urinary Incontinence / Q000601:surgery; D016741:Urinary Sphincter, Artificial