Distal Double Cuff Vs. Transcorporal Cuff as Salvage Options - a Prospective Analysis of Different Artificial Urinary Sphincter (AMS 800) Implantation Sites
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Distal Double Cuff Vs. Transcorporal Cuff as Salvage Options - a Prospective Analysis of Different Artificial Urinary Sphincter (AMS 800) Implantation Sites. / Maurer, Valentin; Dahlem, Roland; Rosenbaum, Clemens M; Gild, Philipp; Vetterlein, Malte W; Schüttfort, Victor; Meyer, Christian P; Riechardt, Silke; Fisch, Margit; Marks, Phillip; Ludwig, Tim A.
in: UROLOGY, Jahrgang 133, 01.11.2019, S. 234-239.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Distal Double Cuff Vs. Transcorporal Cuff as Salvage Options - a Prospective Analysis of Different Artificial Urinary Sphincter (AMS 800) Implantation Sites
AU - Maurer, Valentin
AU - Dahlem, Roland
AU - Rosenbaum, Clemens M
AU - Gild, Philipp
AU - Vetterlein, Malte W
AU - Schüttfort, Victor
AU - Meyer, Christian P
AU - Riechardt, Silke
AU - Fisch, Margit
AU - Marks, Phillip
AU - Ludwig, Tim A
N1 - Copyright © 2019. Published by Elsevier Inc.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - OBJECTIVE: To analyze functional outcomes and complication rates of distal double cuffs (DC) or transcorporal cuffs (TC) as salvage approaches in high-risk patients, since there is an ongoing debate about optimal cuff-placement in a salvage setting (SV). Existing studies analyzing DC or TC are controversial with respect to functional outcomes and complication rates. Studies directly comparing both approaches in SV are scarce.METHODS AND PATIENTS: Prospective data collection was performed since 2009. DC/TC were applied according to a standardized protocol in SV. Salvage DC was chosen in case of a membranous single cuff explantation due to erosion or infection. TC were implanted after bulbar urethroplasty or DC explantation. Activation was performed 6 weeks postoperatively. Further follow-up was scheduled 6/24 months postoperatively and every 2 years thereafter. Primary/secondary endpoints were continence/complication rates.RESULTS: In total, 71 high-risk patients were available for analysis (58 DC, 13 TC). Median age was 70 years. Median follow-up was 24 months. Objective/social continence were 88%/94% in the DC and 72%/100% in the TC cohort, respectively (P = .37/P = 1). Overall, there were no significant differences with respect to infections, erosions, mechanical failure, and explantation rates. The times of explantation-free survival were similar in Kaplan-Meier analysis (Log-rank 0.399).CONCLUSION: Complication and continence rates were not significantly different between both cohorts. Hence, a DC in SV can be considered as equally safe and effective. A sequential implantation (first DC, second TC) may be a viable approach to extend overall AUS incontinence therapy.
AB - OBJECTIVE: To analyze functional outcomes and complication rates of distal double cuffs (DC) or transcorporal cuffs (TC) as salvage approaches in high-risk patients, since there is an ongoing debate about optimal cuff-placement in a salvage setting (SV). Existing studies analyzing DC or TC are controversial with respect to functional outcomes and complication rates. Studies directly comparing both approaches in SV are scarce.METHODS AND PATIENTS: Prospective data collection was performed since 2009. DC/TC were applied according to a standardized protocol in SV. Salvage DC was chosen in case of a membranous single cuff explantation due to erosion or infection. TC were implanted after bulbar urethroplasty or DC explantation. Activation was performed 6 weeks postoperatively. Further follow-up was scheduled 6/24 months postoperatively and every 2 years thereafter. Primary/secondary endpoints were continence/complication rates.RESULTS: In total, 71 high-risk patients were available for analysis (58 DC, 13 TC). Median age was 70 years. Median follow-up was 24 months. Objective/social continence were 88%/94% in the DC and 72%/100% in the TC cohort, respectively (P = .37/P = 1). Overall, there were no significant differences with respect to infections, erosions, mechanical failure, and explantation rates. The times of explantation-free survival were similar in Kaplan-Meier analysis (Log-rank 0.399).CONCLUSION: Complication and continence rates were not significantly different between both cohorts. Hence, a DC in SV can be considered as equally safe and effective. A sequential implantation (first DC, second TC) may be a viable approach to extend overall AUS incontinence therapy.
U2 - 10.1016/j.urology.2019.07.018
DO - 10.1016/j.urology.2019.07.018
M3 - SCORING: Journal article
C2 - 31352019
VL - 133
SP - 234
EP - 239
JO - UROLOGY
JF - UROLOGY
SN - 0090-4295
ER -
