Comparison Study between Artificial Urinary Sphincter and Adjustable Male Sling: A Propensity-Score-Matched Analysis

Area of Science:

• Urology
• Medical Devices
• Surgical Outcomes

Background:

• Urinary incontinence in men often requires surgical intervention.
• Artificial urinary sphincter (AUS) and adjustable male slings (ATOMS) are treatment options.
• Comparing their efficacy and safety is crucial for patient management.

Purpose of the Study:

• To compare the functional outcomes, complication rates, and device survival between AUS and ATOMS.
• To evaluate the safety and efficacy of these two male incontinence devices.

Main Methods:

• Retrospective observational cohort study with propensity score matching (PSM).
• Comparison of functional outcomes (pad test, patient-reported improvement), complications (high-grade, reinterventions, explantations), and device survival.
• 49 patients included in the analysis.

Main Results:

• The ATOMS group reported higher patient satisfaction (81% vs. 71%) and similar dryness rates (22.5% vs. 44.9% - though AUS had a higher dry rate, p=0.03).
• The AUS group experienced significantly more high-grade complications, reinterventions, and explantations.
• Device survival at 60 months was higher for ATOMS (82% vs. 67%, p=0.03).

Conclusions:

• The artificial urinary sphincter (AUS) shows a higher dry rate but is associated with increased high-grade complications and reinterventions.
• The adjustable transurethral male sling (ATOMS) provides good functional outcomes with a lower complication profile.
• ATOMS represents a viable, less invasive alternative for male urinary incontinence management.