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Posted by on Jan 12, 2019 in Urinary incontinence | 0 comments

In a nutshell

This study looked at the safety and effectiveness of artificial urinary sphincters (AUS) in the treatment of stress urinary incontinence (SUI) after prostate surgery. It concluded that AUS is an effective SUI treatment after prostate surgery. 

Some background

Stress incontinence is urine leakage when there is pressure on the bladder. It is often observed when a patient coughs, sneezes or exercises. Stress incontinence happens as a result of weak muscles around the bladder that hold urine in. This muscles can be weakened by surgeries, such as prostate removal. 

Urinary incontinence can be treated by pelvic floor exercises, drug therapy, pessaries (to support the walls of the bladder) or nerve stimulation. Surgery can also be an option when these treatments do not work, but it is only effective for stress incontinence. One such surgery, is the implantation of an artificial urinary sphincter (AUS). AUS works by squeezing the urethra (the tube which carries urine out of the body). This squeezing action stops urine leaking out of the body. Part of the AUS is implanted in the scrotum and when it is pressed, the pressure is removed off of the urethra and urination can take place. it is important to research the safety and effectiveness of this treatment.

Methods & findings

The data of 892 patients were included in this study. These patients had SUI after prostate surgery. AUS were fit into each patient to treat SUI. Patients were assessed for AUS effectiveness. This was carried out by measuring the number of incontinence pads used per day. Safety was assessed through measuring reversal of the AUS surgery. 

27.8% patients had complications after AUS. 6.7% of patients had AUS erosion. 4.2% had an infection. 3.5% suffered from urethral atrophy (wasting away of the tube which takes urine out of the body). 13.2% had mechanical failure (the AUS stops working). Removal of the AUS occurred in 30.6% of patients. 

58% of patients were continent after AUS. Statistical analysis showed that patients who had never had any incontinence surgery before were more likely to have their incontinence cured by AUS surgery. 

The bottom line

This study concluded that AUS is an effective treatment for SUI caused by prostate surgery. 

The fine print

The authors note that the amount of cases the hospital or institution has per year is connected with a patient's likelihood to have successful AUS. 

What’s next?

If you are interested in learning more about AUS to treat SUI, contact our doctor. 

Published By :

Neurourology and urodynamics

Date :

Dec 21, 2018

Original Title :

Efficacy and safety of artificial urinary sphincter (AUS): Results of a large multi-institutional cohort of patients with mid-term follow-up.

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