title: Prospective follow-up study of artificial urinary sphincter placement preserving the bulbospongiosus muscle.
abstract: OBJECTIVE
  Artificial urinary sphincter (AUS) AMS-800® is an effective treatment for male stress urinary incontinence. The aim of the study was to assess the long-term effectiveness and complications of artificial urinary sphincter placement preserving the bulbospongiosus muscle.
  
  
  METHODS
  From April 2004 to March 2014, all consecutive male patients with urinary incontinence who underwent an AUS prosthesis insertion were prospectively evaluated. Surgical technique consisted of a perineal incision for cuff placement around the bulbous urethra preserving the bulbospongiosus muscle. Cure rate was defined as no pad use.
  
  
  RESULTS
  A total of 82 consecutive patients (median age 68 years, range: 54-78) were prospectively evaluated (median follow-up 46 months, range: 12-135). Bulbospongiosus muscles were preserved intact in all cases with no intraoperative complications. Postoperative complications were reported in 14 patients (1 urethral erosion). The overall cure rate (dry rate) was 76.8% and the median ICIQ-UI score improved from 18 (range: 8-21) to 4 (range: 0-17) (P < 0.001). Artificial urinary sphincter survival rate was 95.5% (95%CI 89.4-100%) at 24 months and 62.6% (95%CI 45.5-79.6%) at 60 months. The mechanical failure rate was 6.3% (median 46.1 months, range: 22.2-100.9) and urethral atrophy and/or inadequate compression rate was 9.5% (median 58.6 months, range: 39-101.4 months).
  
  
  CONCLUSIONS
  Our study suggests that placement of AUS preserving the bulbospongiosus muscle is technically easy and efficient, reports excellent continence rates and lower urethral erosion rates, and could delay the onset of urethral atrophy compared to other surgical procedures used for sphincter placement.
authors.affiliation: Department of Urology, Instituto Valenciano de Oncología, Valencia, Spain.
authors.forename: Argimiro
authors.initials: A
authors.lastname: Collado Serra
authors.affiliation: Department of Urology, Instituto Valenciano de Oncología, Valencia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Domínguez-Escrig
authors.affiliation: Department of Urology, Instituto Valenciano de Oncología, Valencia, Spain.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Gómez-Ferrer
authors.affiliation: Department of Urology, Clinica Teknon, Barcelona, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Batista Miranda
authors.affiliation: Department of Urology, Instituto Valenciano de Oncología, Valencia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Rubio-Briones
authors.affiliation: Department of Urology, Instituto Valenciano de Oncología, Valencia, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Solsona Narbón
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016741:Urinary Sphincter, Artificial
keywords: artificial urinary sphincter; atrophy; bulbospongiosus muscle; urethral erosion; urinary incontinence