title: Long-Term Outcomes of the Implant of a Periurethral Constrictor for Stress Urinary Incontinence Following Radical Prostatectomy.
abstract: OBJECTIVE
  To assess morbidity, effectiveness and quality of life (QoL) of implant of Silimed periurethral constrictor (PC) in a consecutive series of patients who had stress urinary incontinence following radical prostatectomy.
  
  
  METHODS
  A prospective non-randomized study designed on patients who underwent implant of Silimed PC. Primary end point was postoperative morbidity and secondary end points were effectiveness of implant and QoL. We performed a sub-analysis of men who received previous radiation and we compared the subpopulation with radiation-naïve patients.
  
  
  RESULTS
  Nineteen patients (31.6%) received pelvic radiation therapy prior implant. All procedures were completed successfully with median operative time of 55 (IQR 50-62.5) min. We recorded 47 (78.3%) postoperative complications in 30 men. Twenty-three men (38.3%) developed urethral erosion at median follow-up of 27.5 (IQR 21-35) months, and 1 man (1.9%) had rectourethral fistula at 2 months. Risk of urethral erosion increased significantly among patients who received radiation (63.1 vs. 26.8%; p < 0.001). In 12 cases (20%), we recorded malfunctioning of the reservoir requiring replacement.
  
  
  CONCLUSIONS
  The implant of Silimed device is not safe due to a high risk of urethral erosion. Careful patient selection and detailed counseling are mandatory when considering the implant of PC in adult patients.
authors.affiliation: Department of Urology, Maggiore della Caritx00E0; Hospital, University of Eastern Piedmont A. Avogadro, Novara, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Favro
authors.forename: Michele
authors.initials: M
authors.lastname: Billia
authors.forename: Alessandro
authors.initials: A
authors.lastname: Volpe
authors.forename: Monica
authors.initials: M
authors.lastname: Zacchero
authors.forename: Carlo
authors.initials: C
authors.lastname: Terrone
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D019736:Prostheses and Implants; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000209:etiology* / Q000601:surgery*