title: Long-term functional outcomes after artificial urinary sphincter implantation in men with stress urinary incontinence.
abstract: OBJECTIVE
  To evaluate long-term functional outcomes of artificial urinary sphincters (AUSs) and to determine how many men required explantation because of stress urinary incontinence (SUI) caused by sphincter deficiency after prostate surgery.
  
  
  METHODS
  Men who had undergone placement of an AUS (American Medical Systems AMS 800®) between 1984 and 1992 to relieve SUI caused by sphincter deficiency after prostate surgery were included. Continence, defined as no need for pads, was assessed at the end of the follow-up. Kaplan-Meier survival curves estimated the survival rate of the device without needing explantation or revision.
  
  
  RESULTS
  In all, 57 consecutive patients were included with a median (interquartile range, IQR) age of 69 (64-72) years. The median (IQR) duration of follow-up was 15 (8.25-19.75) years. At the end of follow-up, 25 patients (43.8%) still had their primary AUS. The AUS was explanted in nine men because of erosion (seven) and infection (two). Survival rates, without AUS explantation, were 87%, 87%, 80%, and 80% at 5, 10, 15, and 20 years, respectively. Survival rates, without AUS revision, were 59%, 28%, 15%, and 5% at 5, 10, 15, and 20 years, respectively. At the end of the follow-up, in intention-to-treat analysis, 77.2% of patients were continent.
  
  
  CONCLUSIONS
  In the long term (>10 years) the AMS 800 can offer a high rate of continence to men with SUI caused by sphincter deficiency, with a tolerable rate of explantation and revision.
authors: Department of Urology, Pitié-Salpétrière Academic Hospital, Paris, France.
authors: Priscilla
authors: P
authors: Léon
authors: Department of Urology, Pitié-Salpétrière Academic Hospital, Paris, France.
authors: Emmanuel
authors: E
authors: Chartier-Kastler
authors: Department of Urology, Pitié-Salpétrière Academic Hospital, Paris, France.
authors: Morgan
authors: M
authors: Rouprêt
authors: Department of Statistics, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, Paris, France.
authors: Vanina
authors: V
authors: Ambrogi
authors: Department of Urology, Pitié-Salpétrière Academic Hospital, Paris, France.
authors: Pierre
authors: P
authors: Mozer
authors: Department of Urology, Pitié-Salpétrière Academic Hospital, Paris, France.
authors: Véronique
authors: V
authors: Phé
mesh_terms: D000368:Aged; D020878:Device Removal; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016741:Urinary Sphincter, Artificial; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000379:methods*
keywords: outcomes; survival; urinary incontinence; urinary sphincter