Long-term outcomes of primary implantation and revisions of artificial urinary sphincter in men with stress urinary incontinence.
OBJECTIVE
To evaluate long-term outcomes of primary implantation and revisions of artificial urinary sphincter (AUS) in men with stress urinary incontinence (SUI).


METHODS
The medical records of 155 consecutive patients who underwent AMS 800™ implantation from 2003 to 2015 were reviewed. Treatment success (TS) was defined as no need for pads, and social continence (SC) was defined as a need for pad ≤1/day at last follow-up. The efficacy, complication rates, and associated risk factors with reoperation and durability of primary AUS implantation, as well as treatment outcomes following AUS revision were evaluated.


RESULTS
The median age was 69.0 years (range 27-85), and median follow-up was 45.1 months (range 9-126). The rates of TS and SC were 63.2% and 84.5%, respectively. The reoperation rate of AUS was 26.4%. Non-mechanical failure (70.7%) was a dominant etiology of reoperation. The 5-year device survival rate without reoperation was 67.0%. The immediate TS rates of primary AUS without reoperation (pAUS) and AUS revision without secondary reoperation (rAUS) groups were 88.6% and 79.2% (P = 0.352), respectively. At last follow-up, the SC rate was higher in patients with pAUS (92.1%) than with rAUS (62.5%) (P = 0.001).


CONCLUSIONS
Although there are appreciable rates of reoperation, the AMS 800™ offers high rates of continence in men with SUI. The immediate TS rate was comparable in patients with pAUS and rAUS. At the final follow-up, however, the SC rate was significantly higher in patients with pAUS than with rAUS.
Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of the National Cancer Center, Goyang, Korea.
Yoon Seok
YS
Suh
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kwang Jin
KJ
Ko
Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
Tae Heon
TH
Kim
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Hyun Hwan
HH
Sung
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.|Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Korea.
Kyu-Sung
KS
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016741:Urinary Sphincter, Artificial; D013521:Urologic Surgical Procedures, Male
artificial urinary sphincter; stress; urinary incontinence