Can artificial urinary sphincter be an effective salvage option in women following failed anti-incontinence surgery?
OBJECTIVE
The role of artificial urinary sphincter (AUS) as salvage option following failed anti-incontinence surgery is unclear.


METHODS
Database review and telephone survey were conducted to review patient satisfaction, surgical outcomes, device failure and revision rates.


RESULTS
A total of 29 female patients received AUS following failed anti-incontinence surgeries. Five (17%) AUS devices were explanted due to AUS erosion or infection. Thirteen AUS revisions were made and device malfunction accounted for 95% of the cases. Kaplan-Meier analysis showed more than 90% of AUS malfunction occurred less than 100 months from the time of implant. There was a significant decrease in pad use (3.6 to 0.2 pads per day; p < 0.01). The continence rate with no pad use was 70% and this increases to 83% in patients wearing one precautionary pad.


CONCLUSIONS
AUS is a safe, durable and effective salvage option for females with previous failed anti-incontinent surgeries.
Chung
Eric
E
Department of Urology, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, Queensland 4102, Australia. ericchg@hotmail.com
Navaratnam
Anojan
A
Cartmill
Ross A
RA
D000328:Adult; D000368:Aged; D004868:Equipment Failure; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D012086:Reoperation; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000601:surgery*; D016741:Urinary Sphincter, Artificial