Skip to Main content Skip to Navigation
Master Thesis

Prevalence and risk factors of artificial urinary sphincter revision in non-neurological male patients

Abstract : Background : to date, the specific causes of revision of an artificial urinary sphincter (AUS) in male patients and their risk factors have been poorly investigated.
Objective: to assess the prevalence and risk factors of male AUS mechanical failures and non-mechanical failures.
Design, setting, and participants: the charts of all male patients who underwent an AUS implantation between 2004 and 2020 in 16 centers were retrospectively reviewed. Patients with neurogenic stress urinary incontinence (SUI) were excluded as well as revisions/explantations for infections and/or erosions.
Intervention: causes of revision were divided into mechanical failures (fluid loss or malfunction from any components of the AUS), non-mechanical failures (urethral atrophy, recurrence/persistence of SUI despite normally functioning device) and other (pump malposition, balloon herniation, hematoma, pain). Outcome measurements and statistical analysis. Failure-free survival analysis was performed both for general and specific causes of revision. Predictors of mechanical and non-mechanical failures were determined by Cox proportional hazards model.
Results and limitations: 1041 patients met the inclusion criteria. After a median follow-up of 20 months, the estimated 5-year and 10-year overall revision free survival were 75% and 50%. There were 221 AUS revisions: 60 (27%) for mechanical failures, 125 (57%) for non-mechanical failures and 36 (16%) other causes of revision. In multivariable Cox regression analysis, larger cuff size was the only predictor of overall revisions (HR=1.04 [1.01 - 1.07]; p=0.006) and revision for non-mechanical failure (HR=1.05 [1.02 - 1.09]; p=0.001).
Conclusions: half of male AUS patients undergo device revision over the first ten years after implantation. Non-mechanical failures are the primary cause of AUS revision in non-neurological men. Larger cuff size appears to be the main determinant of AUS revision’s risk.Patient summary: artificial urinary sphincter (AUS) is the gold-standard treatment of male with stress urinary incontinence (SUI). Half of male AUS patients undergo device revision over the first ten years after implantation mostly for non-mechanical failure. Using larger cuff during AUS implantation may increase that risk.
Document type :
Master Thesis
Complete list of metadata

https://dumas.ccsd.cnrs.fr/dumas-03419612
Contributor : Bibliothèque Universitaire de Médecine Nice Connect in order to contact the contributor
Submitted on : Monday, November 8, 2021 - 3:49:44 PM
Last modification on : Thursday, November 25, 2021 - 3:16:40 AM

Identifiers

  • HAL Id : dumas-03419612, version 1

Citation

Imad Bentellis. Prevalence and risk factors of artificial urinary sphincter revision in non-neurological male patients. Human health and pathology. 2020. ⟨dumas-03419612⟩

Share

Metrics

Record views

8

Files downloads

5