OBJECTIVE: To describe the surgical technique of transcorporal AUS implantation and assess its efficacy on continence and erectile function.
PATIENTS AND METHODS: A prospective evaluation was conducted between December 2007 and October 2012 in a tertiary reference center. All male patients treated by transcorporal AUS (AMS800™, AmericanMedicalSystems, Minnetonka, Minnesota, USA) implantation for SUI recurrence after failure of previous anti-incontinence surgery were included. Functional urinary outcomes were assessed by daily pad use, Urinary Symptom Profile (USP) questionnaire, and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Erectile function was evaluated by International Index of Erectile Function (IIEF-5) questionnaire. Patient satisfaction was assessed by Patient Global Impression of Improvement (PGI-I) questionnaire. Data were collected by telephone interview.
RESULTS: Twenty-three patients were included (mean age 70±7 yr (range: 60-85 yr)). Eighteen patients had urethral atrophy and/or erosion after placement of AUS (11 cases), male sling (four cases) or both (three cases), and five patients had severe urethral atrophy after pelvic radiation therapy. AMS800™ implantation with transcorporal cuff placement was successful in all cases without peroperative complication. Follow-up data over one year was available for 17 patients. After a median follow-up of 20±15 mo (range: 2-59 mo), eight patients were perfectly dry (no pad use and no symptoms), five achieved social continence (less than one pad/day), and four still had SUI (require two or more pads/day). Among six patients who had good pre-operative erectile function and were sexually active, four had no decrease IIEF-5 score.
CONCLUSION: Transcorporal AUS cuff placement is a useful alternative for challenging cases of male SUI in case of failure of previous surgical treatment, urethral atrophy or erosion. Erectile function can be maintained despite dissection of the corporal body.
Written by:
Wiedemann L, Cornu JN, Haab E, Peyrat L, Beley S, Cathelineau X, Haab F. Are you the author?
Department of urology, Groupe hospitalo-universitaire EST, Tenon hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Faculté de médecine Pierre et Marie Curie, University Paris VI, Paris, France.
Reference: BJU Int. 2013 Jul 25. Epub ahead of print.
doi: 10.1111/bju.12386
PubMed Abstract
PMID: 24053170
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