The long-term outcomes of patients with artificial urinary sphincter

This study focused on the long term outcomes of treating urinary incontinence in male patients with an artificial urinary sphincter. Researchers found that most patients did not need a repeat surgery 10 years after the initial implant. 

Urinary incontinence is a condition where people lose the ability to control their bladder. Artificial urinary sphincter is a device that is implanted in the unitary tract to prevent incontinence, and allows for control of the bladder. Artificial urinary sphincters are implanted through surgery. Since there is a risk in undergoing surgery, knowledge on the long term outcomes of artificial urinary sphincter implantation is needed. Possible risks include repeat surgery, infections, and urinary frequency. There is also a need to understand if comorbidities (other medical conditions such as diabetes or high blood pressure), affect the outcome of patients with an artificial urinary sphincter.

This study analyzed the outcomes of 1,632 male patients from 1994-2013. All patients were from Ontario, Canada and received care at the same hospitals. Removal or reimplantation was classified as any procedure that altered or replaced the initial implant.  This study also analyzed if radiation or the performing hospital had any effect on long term outcomes.

Overall, after ten years 66% of patients still had artificial urinary sphincter without any other surgical intervention. A total of 34% of patients had a revision or removal procedure and a 27% had a reimplantation procedure 10 years after follow up. While there was no difference between revision or removal rates at hospitals with low and high numbers of surgeries, there was a lower rate of reimplantation at hospitals with a high number of surgeries. Radiation did not affect revision, removal, or reimplantation rates. Patients with other comorbidities such as diabetes or hypertension, were shown to have a higher risk of removal or revision.

This study found that most patients with artificial urinary sphincters did not need further procedures after the first ten years. Hospitals with a high number of surgeries and patients without other comorbidities had better outcomes.

This study was only conducted in one geographical area, and there are other studies that shown higher rates of intervention after ten years. Further analysis is needed to confirm results from different studies.

Consult your physician about different types of treatment for urinary incontinence.