title: Outcomes of artificial urinary sphincter placement in men after radical cystectomy and orthotopic urinary diversions for the treatment of stress urinary incontinence: the University of Southern California experience.
abstract: OBJECTIVE
  To examine the outcomes of male patients who have undergone artificial urinary sphincter (AUS), AMS-800 (American Medical Systems Minnetonka, MN) placement for iatrogenic stress urinary incontinence after radical cystectomy (RC) and orthotopic neobladder (ONB) diversion in a single institution.
  
  
  METHODS
  From 2002-2009, patients were prospectively randomized to undergo RC and Studer vs T-pouch neobladder reconstruction. We received IRB- approval to retrospectively review the charts of patients who underwent AUS placement for symptoms of SUI. Patients were mailed 2 validated questionnaires, International Continence Society Male-Short Form, the Incontinence Symptom Severity Index, and a pad questionnaire.
  
  
  RESULTS
  Twelve male patients were identified. Average age at time of AUS placement was 73.8 years (range 52-82). Mean time between RC/ONB and AUS placement was 1.53 years (range 1-4). Mean follow-up time after initial AUS placement was 21.7 months (range 12-72). Ten patients (10/12; 83.3%) returned the validated questionnaires. In comparing pre-AUS to post-AUS continence, 90% of patients reported improvement in continence. Three patients deactivated their AUS during the day and activated it at night. There were no erosions (0%) or any mechanical malfunctions of the device (0%) in our cohort. There were no complications or injuries to the ONB during placement of the AUS components.
  
  
  CONCLUSIONS
  AUS is a safe, effective continence procedure for patients with ONB and SUI. Complication rate, urinary symptoms, and quality of life these patients have as determined by validated questionnaires is acceptable.
authors.affiliation: University of Southern California, USC Institute of Urology, Los Angeles, CA 90089-9178, USA. simma@usc.edu
authors.forename: Vannita
authors.initials: V
authors.lastname: Simma-Chiang
authors.forename: David A
authors.initials: DA
authors.lastname: Ginsberg
authors.forename: Kara K
authors.initials: KK
authors.lastname: Teruya
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Boyd
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002140:California; D015653:Cystectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D014547:Urinary Diversion; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016741:Urinary Sphincter, Artificial