Transcorporal artificial urinary sphincter in radiated and non - radiated compromised urethra. Assessment with a minimum 2 year follow-up.
OBJECTIVE
to assess the efficacy of transcorporal artificial urinary sphincter (AUS) implantation on continence for male stress urinary incontinence in cases of prior surgical treatment or/and radiation failure, and as a first option in radiation patients.


METHODS
From March 2007 to August 2012, 37 male patients were treated with transcorporal AUS AMS™ 800. Twelve patients had primary placement of transcorporal cuff, a surgical option due to a previous history of radiation and 25 patients had secondary procedure after failure of AUS or urinary incontinence surgery. Functional urinary outcomes were assessed by daily pad use, 24-hour Pad-test and ICIQ-SF questionnaire. Quality of life and satisfaction were assessed based on I-QoL and PGI-I questionnaires.


RESULTS
After a median of 32 months, the continence rate (0 to 1 pad) was 69.7%. Median pad test was 17.5g (0-159), mean ICIQ-SF score was 7.3/21 (±5.4) and mean I-QoL score was 93.9/110. A total of 88% of the patients reported satisfaction with the AUS. The 5-year actuarial revision-free for AUS total device was 51%. Patients for primary implant for radiation were not more likely to experience revision than non-radiation patients. Preservation of erections was reported in half of the potent patients.


CONCLUSIONS
Transcorporal AUS cuff placement is a useful alternative procedure option for severe male UI treatment, especially in patients with a compromised urethra after prior surgery or radiation. A high continence rate was reported and implantation as first option in radiation patients should be considered.
Department of Urology-Rouen University Hospital-Charles Nicolle, Rouen, France.
Erwann
E
Le Long
Department of Urology-Rouen University Hospital-Charles Nicolle, Rouen, France.
John David
JD
Rebibo
Department of Urology-Rouen University Hospital-Charles Nicolle, Rouen, France.
Francois Xavier
FX
Nouhaud
Department of Urology-Rouen University Hospital-Charles Nicolle, Rouen, France.
Philippe
P
Grise
D000368:Aged; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D011183:Postoperative Complications; D011468:Prostatectomy / Q000009:adverse effects; D011788:Quality of Life; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000528:radiation effects* / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000532:radiotherapy / Q000601:surgery*; D016741:Urinary Sphincter, Artificial