TY - JOUR
T1 - Surgical and Patient Reported Outcomes of Artificial Urinary Sphincter Implantation
T2 - A Multicenter, Prospective, Observational Study
AU - Kaiho, Yasuhiro
AU - Masuda, Hitoshi
AU - Takei, Mineo
AU - Hirayama, Takahiro
AU - Mitsui, Takahiko
AU - Yokoyama, Minato
AU - Kitta, Takeya
AU - Kawamorita, Naoki
AU - Nakagawa, Haruo
AU - Iwamura, Masatsugu
AU - Arai, Yoichi
N1 - Funding Information:
Supported by Japanese Ministry of Education, Culture, Sports, Science and Technology Grant-in-Aid for Scientific Research 26293348.
Publisher Copyright:
© 2018 American Urological Association Education and Research, Inc.
PY - 2018/1
Y1 - 2018/1
N2 - Purpose We performed a multicenter, prospective, observational study to assess outcomes, including changes in continence status and quality of life, after artificial urinary sphincter implantation. Materials and Methods Prospectively enrolled in this study were 135 patients who underwent primary AMS 800™ implantation between 2011 and 2014 at 1 of 5 institutions. Perioperative complications were categorized according to the Clavien-Dindo classification. We estimated the revision-free rate, that is the incidence of patients who did not undergo artificial urinary sphincter revision surgery. Cox regression analysis was performed to identify patient risk factors for revision surgery. The number of pads needed per day, ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form) and KHQ (King's Health Questionnaire) were used to estimate continence status and quality of life preoperatively, and 1, 3 and 12 months postoperatively. Results The artificial urinary sphincter was implanted without major complications. The revision-free rate 1, 2 and 3 years after implantation was 94%, 88% and 81%, respectively. Diabetes mellitus and poor preoperative American Society of Anesthesiologists® physical status were significant risk factors for revision surgery. Continence status and quality of life were markedly improved after surgery. However, ICIQ-SF and some KHQ items showed slight but significant deterioration at 12 months compared with scores 1 month after surgery. Conclusions Artificial urinary sphincter implantation is a safe and durable procedure that substantially improves patient continence status and quality of life soon after surgery. Our results indicate that patients start to experience slight but noticeable deterioration in continence status and quality of life relatively early (within 1 year) after surgery. This finding might be helpful with appropriately counseling patients who undergo artificial urinary sphincter implantation.
AB - Purpose We performed a multicenter, prospective, observational study to assess outcomes, including changes in continence status and quality of life, after artificial urinary sphincter implantation. Materials and Methods Prospectively enrolled in this study were 135 patients who underwent primary AMS 800™ implantation between 2011 and 2014 at 1 of 5 institutions. Perioperative complications were categorized according to the Clavien-Dindo classification. We estimated the revision-free rate, that is the incidence of patients who did not undergo artificial urinary sphincter revision surgery. Cox regression analysis was performed to identify patient risk factors for revision surgery. The number of pads needed per day, ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form) and KHQ (King's Health Questionnaire) were used to estimate continence status and quality of life preoperatively, and 1, 3 and 12 months postoperatively. Results The artificial urinary sphincter was implanted without major complications. The revision-free rate 1, 2 and 3 years after implantation was 94%, 88% and 81%, respectively. Diabetes mellitus and poor preoperative American Society of Anesthesiologists® physical status were significant risk factors for revision surgery. Continence status and quality of life were markedly improved after surgery. However, ICIQ-SF and some KHQ items showed slight but significant deterioration at 12 months compared with scores 1 month after surgery. Conclusions Artificial urinary sphincter implantation is a safe and durable procedure that substantially improves patient continence status and quality of life soon after surgery. Our results indicate that patients start to experience slight but noticeable deterioration in continence status and quality of life relatively early (within 1 year) after surgery. This finding might be helpful with appropriately counseling patients who undergo artificial urinary sphincter implantation.
KW - artificial
KW - patient reported outcome measures
KW - quality of life
KW - urinary bladder
KW - urinary incontinence
KW - urinary sphincter
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U2 - 10.1016/j.juro.2017.08.077
DO - 10.1016/j.juro.2017.08.077
M3 - Article
C2 - 28823767
AN - SCOPUS:85034087335
VL - 199
SP - 245
EP - 250
JO - Investigative Urology
JF - Investigative Urology
SN - 0022-5347
IS - 1
ER -
