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Artificial urinary sphincter for post-prostatectomy incontinence

G Singh1, D G Thomas

  • 1Department of Urology, Royal Hallamshire Hospital, Sheffield, UK.

British Journal of Urology
|February 1, 1996
PubMed
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Artificial urinary sphincters can restore social continence in 96% of men with post-prostatectomy incontinence. However, bulbar cuff placement has a high re-operation rate, necessitating careful patient selection for artificial urinary sphincter implantation.

Area of Science:

  • Urology
  • Surgical Innovation
  • Patient Outcomes

Background:

  • Post-prostatectomy incontinence affects a significant number of men.
  • Sphincter deficiency is a common cause of persistent incontinence after prostatectomy.
  • Artificial urinary sphincters offer a potential solution for restoring continence.

Purpose of the Study:

  • To evaluate the effectiveness and complications of artificial urinary sphincters in managing post-prostatectomy incontinence.
  • To compare outcomes between bulbar and membranous urethral cuff placements.
  • To assess the re-operation rates associated with artificial urinary sphincter implantation.

Main Methods:

  • A cohort of 28 patients with post-prostatectomy incontinence underwent artificial urinary sphincter implantation.

Related Experiment Videos

  • Patients received either a bulbar (n=21) or membranous (n=7) urethral cuff.
  • Follow-up averaged 41 months, with detailed recording of complications and re-operations.

    • Main Results:

    • Overall social continence was achieved in 96% of patients (24 dry, 3 occasional leakage).
    • The bulbar cuff group experienced a 57% re-operation rate due to persistent leakage, system failure, or infection.
    • The membranous cuff group had a lower re-operation rate of 14%.

    Conclusions:

    • Artificial urinary sphincters are effective in achieving social continence for post-prostatectomy incontinence.
    • Bulbar urethral cuffs are associated with a high incidence of post-implantation incontinence and re-operations.
    • Membranous urethral cuffs appear to offer a more durable solution with fewer revisions.