Archivio Italiano di Urologia e Andrologia (Oct 2024)

Single-component artificial urinary sphincter: Outcomes from one centre in Portugal

  • João Aragão Vital,
  • Miguel Marques Monteiro,
  • Bernardo Lobão Teixeira,
  • Gonçalo Grilo Mendes,
  • Alexandra Rocha,
  • Mariana Madanelo,
  • Sofia Mesquita,
  • Nuno Vinagre,
  • Beatriz Oliveira,
  • Martinha Magalhães,
  • Ana Isabel Lopes,
  • Carlos Ferreira,
  • Paulo Príncipe,
  • Avelino Fraga

DOI
https://doi.org/10.4081/aiua.2024.12661
Journal volume & issue
Vol. 96, no. 3

Abstract

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Purpose: Radical prostate cancer treatment is the predominant cause of iatrogenic stress urinary incontinence (SUI) in men, significantly impacting their quality of life (QoL). This prospective single-center study in Portugal aimed to evaluate the outcomes of men with moderate-to-severe SUI treated with a single-component artificial urinary sphincter (AUS). Materials and methods: Male patients with iatrogenic moderate-to-severe SUI, determined by a 24-hour pad weight test, were included. The single-component device comprises a cuff linked to a pump unit through a kink-resistant tube. The implantation involved perineal incision for cuff placement and an inguinal incision for pump and tank positioning within the scrotum. Complications, pad usage, perioperative complications (Clavien-Dindo classification), and quality of life assessment using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire were documented. Results: Between May 2021 and March 2023, 20 consecutive single-component AUS insertions were conducted at a Portuguese urology department. Follow-up concluded in July 2023, with a mean follow-up duration of 15 months (range: 5-27). Four patients experienced complications necessitating device revision or removal (erosion = 2, infection = 1, mechanical failure = 1). Social continence (0/1 pad/day) was achieved in 70% (14/20 patients), while 30% (6/20 patients) experienced incontinence. Perioperatively, one patient was classified as grade 2, while the remaining were grade 0/1 in the Clavien-Dindo classification. The mean ICIQ-SF score reduction was 10.5 points. Conclusions: The single-component AUS shows promising efficacy in managing moderate-to-severe male SUI, offering a good success rate, acceptable complications, improved QoL, and a straightforward surgical procedure.

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