Artificial urinary sphincters for male stress urinary incontinence: current perspectives

Billy H Cordon,1 Nirmish Singla,1 Ajay K Singla2 1Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, 2Department of Urology, University of Toledo College of Medicine, Toledo, OH, USA Abstract: The artificial urinary sphincter (AUS), which has evolved over many years,...

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Autores principales:	Cordon BH, Singla N, Singla AK
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Artificial Urinary Sphincter stress urinary incontinence post prostatectomy incontinence prostheses and implants review Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/4a4d2d23b5ac4939bf188645add9467d
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spelling	oai:doaj.org-article:4a4d2d23b5ac4939bf188645add9467d2021-12-02T06:26:40ZArtificial urinary sphincters for male stress urinary incontinence: current perspectives1179-1470https://doaj.org/article/4a4d2d23b5ac4939bf188645add9467d2016-07-01T00:00:00Zhttps://www.dovepress.com/artificial-urinary-sphincters-for-male-stress-urinary-incontinence-cur-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470Billy H Cordon,1 Nirmish Singla,1 Ajay K Singla2 1Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, 2Department of Urology, University of Toledo College of Medicine, Toledo, OH, USA Abstract: The artificial urinary sphincter (AUS), which has evolved over many years, has become a safe and reliable treatment for stress urinary incontinence and is currently the gold standard. After 4 decades of existence, there is substantial experience with the AUS. Today AUS is most commonly placed for postprostatectomy stress urinary incontinence. Only a small proportion of urologists routinely place AUS. In a survey in 2005, only 4% of urologists were considered high-volume AUS implanters, performing >20 per year. Globally, ~11,500 AUSs are placed annually. Over 400 articles have been published regarding the outcomes of AUS, with a wide variance in success rates ranging from 61% to 100%. Generally speaking, the AUS has good long-term outcomes, with social continence rates of ~79% and high patient satisfaction usually between 80% and 90%. Despite good outcomes, a substantial proportion of patients, generally ~25%, will require revision surgery, with the rate of revision increasing with time. Complications requiring revision include infection, urethral atrophy, erosion, and mechanical failure. Most infections are gram-positive skin flora. Urethral atrophy and erosion lie on a spectrum resulting from the same problem, constant urethral compression. However, these two complications are managed differently. Mechanical failure is usually a late complication occurring on average later than infection, atrophy, or erosions. Various techniques may be used during revisions, including cuff relocation, downsizing, transcorporal cuff placement, or tandem cuff placement. Patient satisfaction does not appear to be affected by the need for revision as long as continence is restored. Additionally, AUS following prior sling surgery has comparable outcomes to primary AUS placement. Several new inventions are on the horizon, although none have been approved for use in the US at this point. Keywords: artificial urinary sphincter, stress urinary incontinence, post prostatectomy incontinence, prostheses and implants, reviewCordon BHSingla NSingla AKDove Medical PressarticleArtificial Urinary Sphincterstress urinary incontinencepost prostatectomy incontinenceprostheses and implantsreviewMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol 2016, Iss Issue 1, Pp 175-183 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Artificial Urinary Sphincter stress urinary incontinence post prostatectomy incontinence prostheses and implants review Medical technology R855-855.5
spellingShingle	Artificial Urinary Sphincter stress urinary incontinence post prostatectomy incontinence prostheses and implants review Medical technology R855-855.5 Cordon BH Singla N Singla AK Artificial urinary sphincters for male stress urinary incontinence: current perspectives
description	Billy H Cordon,1 Nirmish Singla,1 Ajay K Singla2 1Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, 2Department of Urology, University of Toledo College of Medicine, Toledo, OH, USA Abstract: The artificial urinary sphincter (AUS), which has evolved over many years, has become a safe and reliable treatment for stress urinary incontinence and is currently the gold standard. After 4 decades of existence, there is substantial experience with the AUS. Today AUS is most commonly placed for postprostatectomy stress urinary incontinence. Only a small proportion of urologists routinely place AUS. In a survey in 2005, only 4% of urologists were considered high-volume AUS implanters, performing >20 per year. Globally, ~11,500 AUSs are placed annually. Over 400 articles have been published regarding the outcomes of AUS, with a wide variance in success rates ranging from 61% to 100%. Generally speaking, the AUS has good long-term outcomes, with social continence rates of ~79% and high patient satisfaction usually between 80% and 90%. Despite good outcomes, a substantial proportion of patients, generally ~25%, will require revision surgery, with the rate of revision increasing with time. Complications requiring revision include infection, urethral atrophy, erosion, and mechanical failure. Most infections are gram-positive skin flora. Urethral atrophy and erosion lie on a spectrum resulting from the same problem, constant urethral compression. However, these two complications are managed differently. Mechanical failure is usually a late complication occurring on average later than infection, atrophy, or erosions. Various techniques may be used during revisions, including cuff relocation, downsizing, transcorporal cuff placement, or tandem cuff placement. Patient satisfaction does not appear to be affected by the need for revision as long as continence is restored. Additionally, AUS following prior sling surgery has comparable outcomes to primary AUS placement. Several new inventions are on the horizon, although none have been approved for use in the US at this point. Keywords: artificial urinary sphincter, stress urinary incontinence, post prostatectomy incontinence, prostheses and implants, review
format	article
author	Cordon BH Singla N Singla AK
author_facet	Cordon BH Singla N Singla AK
author_sort	Cordon BH
title	Artificial urinary sphincters for male stress urinary incontinence: current perspectives
title_short	Artificial urinary sphincters for male stress urinary incontinence: current perspectives
title_full	Artificial urinary sphincters for male stress urinary incontinence: current perspectives
title_fullStr	Artificial urinary sphincters for male stress urinary incontinence: current perspectives
title_full_unstemmed	Artificial urinary sphincters for male stress urinary incontinence: current perspectives
title_sort	artificial urinary sphincters for male stress urinary incontinence: current perspectives
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/4a4d2d23b5ac4939bf188645add9467d
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Artificial urinary sphincters for male stress urinary incontinence: current perspectives

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