In a nutshell
This study examined if artificial urinary sphincters (AUS) are safe and effective long-term in women with stress urinary incontinence (SUI). This study concluded that AUS implants are a safe and effective long-term treatment for SUI.
Some background
Stress urinary incontinence (SUI) mainly affects women. It can occur due to pregnancy with a difficult delivery, obesity, and pelvic floor problems. Treatment may include lifestyle changes, pelvic floor muscle or bladder training. If these are unsuccessful, surgery may be necessary. In some cases, an artificial urinary sphincter (AUS) may be required. The AUS is a device that is put inside the body to help control leakage of urine.
It is not known if AUSs are safe and effective long-term.
Methods & findings
74 women with SUI had an AUS surgically implanted. This was done by a laparoscopic (keyhole) surgery. Patients were followed up for an average of 44.5 months after surgery.
At follow-up, 78.3% of patients were totally continent (no urine leakage). 18.6% of patients had improvements in their symptoms.
Complications during surgery included one vaginal and one urethral perforation (where a small hole was made). These were both repaired during surgery. 5.4% of patients suffered repeated urinary infections. 6.8% of patients experienced retention of urine (they were unable to urinate). 4% of patients had urethral and 2.7% of patients had vaginal erosions (wearing down of tissues). The AUS was reinserted in 13.5% of patients due to failure. The AUS was permanently removed in 10.8% of patients.
The bottom line
This study concluded AUS implants are a safe and effective long-term treatment for women with SUI.
The fine print
This study did not account for the quality of life of patients. Also, AUS was not compared to other treatment methods for SUI. Further studies are needed.
Published By :
BJU international
Date :
Dec 11, 2018
