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Review
. 2020 Feb 4;18(2):78-87.
doi: 10.1080/2090598X.2020.1716293.

A systematic review and meta-analysis of clinical and functional outcomes of artificial urinary sphincter implantation in women with stress urinary incontinence

Bara Barakat  1 , Knut Franke  1 , Sameh Hijazi  2 , Samer Schakaki  3 , Ulrich Gauger  4 , Viktoria Hasselhof  5 , Thomas-Alexander Vögeli  6
Affiliations
Review

A systematic review and meta-analysis of clinical and functional outcomes of artificial urinary sphincter implantation in women with stress urinary incontinence

Bara Barakat et al. Arab J Urol. .

Abstract

Objective: To evaluate the complications and results of artificial urinary sphincter (AUS) implantation in women with stress urinary incontinence (SUI).

Methods: A selective database search using keywords (1990-2019) was conducted to validate the effectiveness of the AUS in women. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilised. The meta-analysis included 964 women (15 studies) with persistent SUI. The Newcastle-Ottawa score was used to determine the quality of the evidence in each study. The success rate and complications associated with the AUS were analysed.

Results: Meta-analysis of the published studies showed that complete continence was achieved at a mean rate of 79.6% (95% confidence interval [CI] 72.2-86.6%) and a significant improvement was achieved in 15% (95% CI 10-25%). The mean (range) follow-up was 22 (6-204) months. The mean number of patients per study was 68. The mean (range) explantation rate was 13 (0-44)%. Vaginal erosion occurred in a mean (range) of 9 (0-27)% and mechanical complications in 13 (0-47)%. Infections accounted for 7% of the complications. The total mean (range) revision rate of the implanted AUS was 15.42 (0-44)%. The mean (range) size of the cuff used was 6.7 (5-10) cm.

Conclusion: Our present analysis showed that implantation of an AUS in women with severe UI is an effective treatment option after failure of first-line therapy. However, the currently available study population is too small to draw firm conclusions.

Abbreviations: AMS: American Medical Systems; AUS: artificial urinary sphincter; EAU: European Association of Urology; LE: Level of Evidence; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; QoL: quality of life; SHELTER: Services and Health for Elderly in Long TERm care (study); SUI: (stress) urinary incontinence.

Keywords: Artificial urinary sphincter; stress urinary incontinence; urinary incontinence.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Study selection flow chart, systematic PRISMA search strategy.
Figure 2.
Figure 2.
Meta-analysis; heterogeneity of the continence rate 79.6% (95% CI 72.2–86.6%).
Figure 3.
Figure 3.
Meta-analysis; heterogeneity of the social continence rate 11.4% (95% CI 9.3–13.9%).
See this image and copyright information in PMC

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References

    1. Hunskaar S, Lose G, Sykes D, et al. The prevalence of urinary incontinence in women in four European countries. BJU Int. 2004;93:324–330. - PubMed
    1. Onder G, Carpenter I, Finne-Soveri H, et al. Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study. BMC Health Serv Res. 2012;12:5. - PMC - PubMed
    1. Brocklehurst JC. Urinary incontinence in the community: analysis of a MORI poll. Br Med J. 1993;306:832–834. - PMC - PubMed
    1. U.S. Food and Drug Administration . FDA public health notification: serious complications associated with transvaginal placement of surgical mesh in repair of pelvic organ prolapse and stress urinary incontinence. [updated 2008 October20; cited 2019 Dec] . Available from: http://www.fda.gov/cdrh/safety/102008-surgicalmesh.html - PubMed
    1. Foley E. An artificial sphincter; a new device and operation for control of enuresis and urinary incontinence. J Urol. 1947;58:250–259. - PubMed

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