Stress urinary incontinence in female neurological patients: long-term functional outcomes after artificial urinary sphincter (AMS 800(TM) ) implantation

AIMS - To report the long-term functional outcomes of artificial urinary sphincter (AUS) implantation in female adult neurological patients suffering from stress urinary incontinence (SUI) due to sphincter deficiency.

METHODS - Female patients with neurological disease suffering from SUI due to sphincter deficiency who underwent AUS (AMS 800(TM) ) implantation between 1984 and 2011 were included. Continence rate defined as no need for pads and survival rates of the device without needing explantation or revision using Kaplan-Meier curves were reported.

RESULTS - Overall, 26 patients, median age 49.2 years (IQR 28.5-59.7) were included. The median follow-up time was 7.5 years (IQR 3.9-23.8). At the end of follow-up period, 15 patients (57.7%) still had their primary AUS. The AUS was explanted in five women because of infection or erosion. Survival rates, without AUS explantation were 90%, 84%, 84%, and 74% at 5, 10, 15, 20 years, respectively. Survival rates without AUS revision were 75%, 51%, 51%, and 51% at 5, 10, 15, 20 years, respectively. 71.4% of patients with AUS were continent. When considering the 26 initial patients, including the patients in whom the AUS was explanted, the continence rate was 57.7%.

CONCLUSIONS - For treating neurogenic sphincter deficiency in the long term, the AMS 800(TM) can offer a satisfying rate of continence to female patients, with a tolerable rate of explantation and revision. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc.

Neurourology and urodynamics. 2016 Apr 15 [Epub ahead of print]

Véronique Phé, Priscilla Léon, Benjamin Granger, Pierre Denys, Marc-Olivier Bitker, Pierre Mozer, Emmanuel Chartier-Kastler

Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, Paris, France., Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, Paris, France., Department of Statistics, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, Paris, France., Department of Physical Medicine and Rehabilitation, Raymond Poincaré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France., Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, Paris, France., Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, Paris, France., Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, Paris, France.