Early Efficacy and Safety Outcomes of Artificial Urinary Sphincter for Stress Urinary Incontinence Following Radical Prostatectomy or Benign Prostatic Obstruction Surgery: Results of a Large Multicentric Study.

Artificial urinary sphincter (AUS) is the gold standard for the management of moderate to severe stress urinary incontinence (SUI) in the male population. While outcomes of this device in postprostatectomy incontinence (PPI) are widely described, those obtained for incontinence after benign prostatic obstruction (BPO) surgery remains poorly explored.

To compare continence outcomes after AUS implantation in a PPI population with those obtained in men incontinent after BPO surgery.

A retrospective review of all cases of AUS implantation between 2005 and 2020 in 16 different French centers was conducted. Only patients with primary implantation whose indication was moderate to severe SUI after prostatectomy or BPO surgery were included (excluding those with a history of radiation therapy, brachytherapy, cystectomy, high-intensity focused ultrasound therapy, or neurogenic disease).

The primary endpoint was the rate of social continence (zero or one pad per day) at 3 mo. Complications were also noted within 90 d of implantation.

A total of 417 patients were included in the PPI group and 50 in the BPO surgery group. Social continence rates at 3 mo were similar between the groups (79% vs 72%, p = 0.701). Complication rate was significantly higher in the BPO group (8% vs 18%, p = 0.044). The same was found for the Clavien-Dindo type 2 complication rate (20.6% vs 44.4%, p = 0.026). The retrospective nature and lack of precise definition of incontinence are the main limitations of this study.

This multicentric study strengthens the position of AUS as gold standard for SUI after radical prostatectomy. Comparable efficacy results were found for incontinence after BPO surgery, with nevertheless a higher rate of complications.

Artificial urinary sphincter represents the gold standard for the treatment of moderate to severe stress urinary incontinence. Efficacy results are comparable between postprostatectomy incontinence and incontinence after benign prostatic obstruction surgery.

European urology focus. 2021 Sep 18 [Epub ahead of print]

Hugo Georges Arthur Dupuis, Imad Bentellis, Mehdi El-Akri, Thibaut Brierre, Tiffany Cousin, Victor Gaillard, Baptiste Poussot, Thibault Tricard, Nicolas Hermieu, Damien Robin, Alice Pitout, Florian Beraud, Matthieu Durand, Daniel Chevallier, Franck Bruyere, Xavier Biardeau, Hervé Monsaint, Luc Corbel, Priscilla Leon, Jean-Francois Hermieu, Pierre Lecoanet, Grégoire Capon, Xavier Game, Christian Saussine, Benoit Peyronnet, Jean-Nicolas Cornu

Department of Urology, Charles Nicolle University Hospital, Rouen, France. Electronic address: ., Department of Urology, University of Nice, Nice, France., Department of Urology, University of Rennes, Rennes, France., Department of Urology, University of Toulouse, Toulouse, France., Department of Urology, University of Bordeaux, Bordeaux, France., Department of Urology, University of Strasbourg, Strasbourg, France., Department of Urology, Bichat Hospital, Paris, France., Department of Urology, University of Reims, Reims, France., Department of Urology, University of Nancy, Nancy, France., Department of Urology, University of Lille, Lille, France., Department of Urology, University of Tours, Tours, France., Department of Urology, Clinique Oceane, Vannes, France., Department of Urology, Clinique Plérin, Plérin, France., Department of Urology, Clinique Pasteur, Royan, France., Department of Urology, Charles Nicolle University Hospital, Rouen, France.

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