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Artificial urinary sphincter

A Gevorgyan, J-F Hétet, M Robert, V Duchattelle-Dussaule, L Corno, I Boulay, H Baumert
OBJECTIVE: To study the oncologic and functional results of salvage cryotherapy after failure of external radiotherapy and brachytherapy. MATERIALS AND METHODS: Patients treated by total salvage cryotherapy (3rd generation) in 2 centers (Groupe Hospitalier Saint-Joseph in Paris and Clinique Jule-Verne Nantes) in between January 2008 and April 2016 were included. The biochemical recurrence-free survival (BRFS) was calculated using the Phoenix criteria (PSA>nadir+2ng/mL)...
March 15, 2018: Progrès en Urologie
Arnav Srivastava, Gregory A Joice, Hiten D Patel, Madeleine G Manka, Nikolai A Sopko, E James Wright
BACKGROUND: Up to 50% of patients receiving an artificial urinary sphincter (AUS) require surgical revision after initial placement. However, the literature is heterogeneous regarding the leading causes of AUS failure and appropriate surgical management. OBJECTIVE: To inform a revision approach by tabulating the causes of AUS failure, assessing AUS component survival, and examining the single-component revision efficacy. DESIGN, SETTING, AND PARTICIPANTS: We retrospectively reviewed 168 patients receiving AUS placements carried out by a single surgeon from 2008 to 2016 at a high-volume academic institution...
March 12, 2018: European Urology Focus
Myong Kim, Daehun Choi, Jun Hyuk Hong, Choung-Soo Kim, Hanjong Ahn, Myung-Soo Choo
OBJECTIVES: To investigate the clinical and urodynamic parameters affecting the treatment outcomes of post-prostatectomy incontinence (PPI) surgery. PATIENTS AND METHODS: We reviewed the patients with PPI who received an artificial urinary sphincter (AUS) or adjustable male sling (MS) from 2001 to 2016. RESULTS: A total of 103 patients (AUS, 53; adjustable MS, 50) with a mean age of 69.9 (±5.6, standard deviation) years were analyzed. The mean number of pads used daily was 4...
March 5, 2018: Neurourology and Urodynamics
Vidhush K Yarlagadda, Meredith L Kilgore, John P Selph
AIM: To identify the costs of replacing an entire malfunctioning AUS device versus an individual component at the time of device malfunction. METHODS: Decision analysis was performed by analyzing the costs associated with revising a malfunctioning artificial urinary sphincter using one of two techniques: either individual or entire device replacement. Costs were determined by including actual institutional costs. Model assumptions were based on a summary of published literature and were created based on a time horizon of 0-5 years since the original, primary AUS was placed, and models were created for malfunction of each individual component...
February 28, 2018: Neurourology and Urodynamics
Lynda Constable, Nikki Cotterill, David Cooper, Cathryn Glazener, Marcus J Drake, Mark Forrest, Chris Harding, Mary Kilonzo, Graeme MacLennan, Kirsty McCormack, Alison McDonald, Anthony Mundy, John Norrie, Robert Pickard, Craig Ramsay, Rebecca Smith, Samantha Wileman, Paul Abrams
BACKGROUND: Stress urinary incontinence (SUI) is a frequent adverse effect for men undergoing prostate surgery. A large proportion (around 8% after radical prostatectomy and 2% after transurethral resection of prostate (TURP)) are left with severe disabling incontinence which adversely effects their quality of life and many are reliant on containment measures such as pads (27% and 6% respectively). Surgery is currently the only option for active management of the problem. The overwhelming majority of surgeries for persistent bothersome SUI involve artificial urinary sphincter (AUS) insertion...
February 21, 2018: Trials
Jeffrey Loh-Doyle, Mukul B Patil, Hari Sawkar, Kevin Wayne, Stuart D Boyd
BACKGROUND: After radical cystoprostatectomy (RC), postoperative erectile dysfunction (ED) is a common consequence with multiple contributing etiologies. The inflatable penile prosthesis (IPP) offers patients a definitive treatment option when ED is refractory to medical therapies. Because of the hostile postoperative anatomy of these patients, a careful surgical approach is necessary for successful outcomes and to avoid adjacent organ injury. To date, there is no series describing the outcomes of 3-piece IPP placement in patients with urinary diversions...
February 13, 2018: Journal of Sexual Medicine
T A Ludwig, R Dahlem
Artificial urinary sphincters and penile corpus cavernosum prostheses are effective for patients who are not adequately treated by conservative treatment or pharmacotherapy. Both of these devices show good results concerning functional outcome if used within the correct patient selection. Penile prostheses are meant to be the last line of treatment for severe erectile dysfunction after failure of conventional treatment. Artificial urinary sphincters are the treatment of choice for severe urinary stress incontinence...
February 7, 2018: Der Urologe. Ausg. A
Flavio Trigo Rocha, Jean Felipe Prodocimo Lesting
Case Hypothesis: Surgical removal is the standard treatment for artificial sphincter extrusion. However in some specific situations is possible to maintain the prosthesis with good results. CASE REPORT: We report a 60 years old patient presenting sphincter pump extrusion one month after artificial urinary sphincter (AUS) AMS 800™ placement for treating post-radical prostatectomy urinary incontinence (PRPUI). He also had a penile prosthesis implant one year before that was replaced in the same surgery the sphincter was implanted...
February 8, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Vahudin Zugor, Ilgar Akbarov, Leonidas Karapanos, Axel Heidenreich
Stress urinary incontinence in women is a common problem in Germany, with approx. 5 million women suffering from incontinence symptoms. These numbers are increasing, due to demographic changes; the suspected numbers are even higher. Prior to treatment, an extended diagnostic approach - including urodynamics and cystoscopy when necessary - is essential for optimal treatment selection.Primary treatment should be conservative, with pelvic floor training as an essential part of a multi-modal treatment concept. If conservative treatment fails, surgery is necessary and an increasing number of women are being treated with sub-urethral slings...
February 2018: Aktuelle Urologie
Xavier Biardeau, Sami Hached, Oleg Loutochin, Lysanne Campeau, Mohamad Sawan, Jacques Corcos
INTRODUCTION: We aimed to present three novel remotely controlled hydromechanical artificial urinary sphincters (AUSs) and report their in-vitro and ex-vivo results. METHODS: We successively developed three distinct hydromechanical AUSs on the basis of the existing AMS800™ device by incorporating an electronic pump. No changes were made to the cuff and balloon. The AUS#1 was designed as an electromagnetically controlled device. The AUS#2 and AUS#3 were conceived as Bluetooth 2...
October 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Andrew Jason Cohen, Kristine Kuchta, Sangtae Park, Jaclyn Milose
PURPOSE: To assess population-based trends in artificial urinary sphincter (AUS) placement after prostatectomy and determine the effect of timing on device survival and complications. METHODS: We identified patients who underwent prostatectomy and AUS placement in SEER-Medicare from 2002 to 2011. We analyzed factors affecting the time of reoperation from AUS implantation and prostatectomy using multivariable Cox proportional hazard models. RESULTS: In total, 841 men underwent AUS placement at a median 23 months after prostatectomy...
January 30, 2018: World Journal of Urology
Allen F Morey
No abstract text is available yet for this article.
February 2018: Journal of Urology
Nathan Chertack, Bradley C Gill, Kenneth W Angermeier, Drogo K Montague, Hadley M Wood
Background: To determine which preoperative factors drive patient-reported quality of life (QoL) after artificial urinary sphincter (AUS) implantation. Methods: Men receiving AUS after prostate cancer treatment were identified from a prospectively collected dataset. Preoperative factors were recorded during the initial incontinence consultation. Patients underwent urodynamic testing (UDS) preoperatively at surgeon discretion. Patients were surveyed by telephone postoperatively and given the EPIC Urinary Domain (EPIC-UD) and Urinary Distress Inventory (UDI-6) questionnaires...
December 2017: Translational Andrology and Urology
S Mitchell Heiner, Boyd R Viers, Marcelino E Rivera, Brian J Linder, Daniel S Elliott
Purpose: Functional characteristics and durability of the artificial urinary sphincter (AUS) among patients who develop bladder cancer has been poorly characterized. We sought to evaluate AUS outcomes among patients subsequently diagnosed with bladder cancer, in order to describe device survivability when subject to diagnostic and therapeutic procedures such as cystoscopy, transurethral resection, and cystectomy. Materials and Methods: We retrospectively reviewed 1,803 male patients treated with AUS surgery at a single institution between 1983-2014...
January 2018: Investigative and Clinical Urology
Lucas Freton, Lauranne Tondut, Isabelle Enderle, Juliette Hascoet, Andrea Manunta, Benoit Peyronnet
INTRODUCTION AND HYPOTHESIS: The objective was to compare the outcomes of the ACT® device with those of the artificial urinary sphincter (AUS) AMS 800 in the treatment of stress urinary incontinence (SUI) due to sphincter deficiency in women. METHODS: All the women who underwent surgical treatment for SUI due to intrinsic sphincter deficiency from 2007 to 2017 were included in a single-center retrospective study. The primary endpoint was the functional outcome...
January 13, 2018: International Urogynecology Journal
Fan Zhang, Limin Liao
BACKGROUND: We review our outcomes and experience of artificial urinary sphincter implantation for patients with refractory urinary incontinence from different causes. METHODS: Between April 2002 and May 2017, a total of 32 patients (median age, 40.8 years) with urinary incontinence had undergone artificial urinary sphincter placement during urinary tract reconstruction. Eighteen patients (56.3%) were urethral injuries associated urinary incontinence, 9 (28.1%) had neurogenic urinary incontinence and 5 (15...
January 8, 2018: BMC Urology
Arman A Kahokehr, Andrew C Peterson
OBJECTIVE: To describe the dramatic and rapid unmasking of urinary-pubic symphysis fistula (UPF) and chronic osteomyelitis after artificial urinary sphincter (AUS) implantation. This has never been reported as UPF is usually an insidious sequelae of radiotherapy or energy ablation for prostate cancer. METHODS: We prospectively identified men who underwent rapid clinical decline due to UPF soon after AUS implantation at our institution in the previous 24 months. Chart and imaging was reviewed to assess preoperative and postoperative factors...
December 23, 2017: Urology
Chad R Pusateri, Jack M Zuckerman
INTRODUCTION: To evaluate the percent of AdVance male sling usage relative to artificial urinary sphincters (AUS) over a 9 year period since its introduction in order to assess trends across the United States. MATERIALS AND METHODS: As a surrogate for procedures performed, we reviewed device utilization trends of the AdVance sling and AUS broken down by American Urological Association (AUA) section. ANOVA testing between years was used to determine purchasing trends with p values of < 0...
December 2017: Canadian Journal of Urology
Kenneth J DeLay, Nora M Haney, Jason Chiang, Carrie Stewart, Faysal A Yafi, Kenneth Angermeier, Hadley Wood, Timothy Boone, Alex G Kavanagh, Matthew Gretzer, Stuart Boyd, Jeffrey C Loh-Doyle, Wayne J G Hellstrom
OBJECTIVE: To determine if the timing of radiation therapy on artificial urinary sphincter (AUS) impacts complication rates, revision rates, and number of pads per day after placement. METHODS: A retrospective review was conducted of men with prostate cancer who underwent AUS placement and radiation therapy between 1987 and 2016. RESULTS: Of 306 men, 292 (95.4%) received radiation before AUS placement (group 1) and 14 (4.6%) received radiation after AUS placement (group 2)...
December 6, 2017: Urology
B Maximilien, A Aublea, A Gillibert, C Delcourt, P Grise, J-N Cornu
OBJECTIVES: To report our experience of inflating or changing pressure balloon to treat recurrent urinary incontinence after AMS800® implantation instead of changing all the devices. PATIENTS AND METHODS: A retrospective study was conducted in a tertiary reference center between 2005 and 2015. All patients, treated by AMS800® implantation for post-prostatectomy urinary incontinence and whom balloon was subsequently changed or inflated, were included. Main clinical end point was the need for another surgery...
March 2018: Progrès en Urologie
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