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. 2020 Feb 4;18(5):1279-1285.
doi: 10.5114/aoms.2019.90803. eCollection 2022.

Artificial urinary sphincter implantation with periprostatic cuff placement for urinary incontinence in men

Tomasz Szopiński  1 , Iwona Sudoł-Szopińska  2 , Anna K Czech  1 , Jerzy Gąsowski  3 , Piotr L Chłosta  1
Affiliations

Artificial urinary sphincter implantation with periprostatic cuff placement for urinary incontinence in men

Tomasz Szopiński et al. Arch Med Sci. .

Abstract

Introduction: Artificial urinary sphincter (AUS) implantation is the treatment of choice for male urinary incontinence (UI). The aim of the present study was to evaluate treatment outcomes of UI in men using an AUS with a cuff placed around the prostatic urethra.

Material and methods: Forty-three men with preserved prostatic urethra were selected for AUS implantation due to UI. Twenty patients had the cuff implanted around the prostate using the retropubic approach (Group 1), and 23 had the cuff placed around the bulbous urethra (Group 2). Both groups were compared in terms of continence quality as well as intra- and postoperative complications.

Results: The groups were comparable with respect to age and duration of follow-up. Median time to complications was 90.3 and 10.7 months in Group 1 and Group 2, respectively (p = 0.007). The complication rate was 40% and 58.3% in Group 1 and 2, respectively (p = 0.001). Complete continence was obtained in 80% of patients from Group 1 and 33.3% of men from Group 2A (p = 0.001).

Conclusions: The analysis indicates that cuff placement around the prostatic urethra results in better continence and is characterised by fewer complications. This method is dedicated for patients who have not had the prostate gland removed. Due to the retrospective nature of this analysis and small groups of patients, it is not possible to formulate ultimate recommendations.

Keywords: artificial urinary sphincter; incontinence; male; prostate; urethra; urinary.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Radiographic images of AMS 800 implanted on bulbar urethra: A – a balloon in the pelvis, B – cuff around the bulbous urethra, C – control pump in the scrotum
Figure 2
Figure 2
Intraoperative picture of the cuff implanted and closed around the bulbous urethra
Figure 3
Figure 3
Radiographic images of the AMS 800 implanted around the prostate: A – a balloon in the Retzius space, B – the cuff size 10 cm around the prostate
Figure 4
Figure 4
Intraoperative picture of the cuff implanted and closed around the prostate
See this image and copyright information in PMC

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