https://doi.org/10.4081/aiua.2024.12661

Single-component artificial urinary sphincter: Outcomes from one centre in Portugal

Vol. 96 No. 3 (2024)
Submitted: May 13, 2024
Accepted: June 6, 2024
Published: October 2, 2024
artificial urinary sphincter, Zephyr Surgical Implants 375, male stress urinary incontinence, radical prostatectomy, quality of life
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Authors

João Aragão Vital
joaopvital@gmail.com
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.
Miguel Marques Monteiro
https://orcid.org/0000-0002-8222-0511
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.
Bernardo Lobão Teixeira
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.
Gonçalo Grilo Mendes
https://orcid.org/0000-0001-5306-1200
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.
Alexandra Rocha
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.
Mariana Madanelo
https://orcid.org/0000-0001-8429-7785
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.
Sofia Mesquita
https://orcid.org/0000-0001-8482-5314
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.
Nuno Vinagre
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.
Beatriz Oliveira
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.
Martinha Magalhães
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.
Ana Isabel Lopes
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.
Carlos Ferreira
https://orcid.org/0000-0003-1879-0189
Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal.
Paulo Príncipe
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.
Avelino Fraga
Centro Hospitalar Universitário de Santo António (CHUdSA), Porto, Portugal.

Purpose: Radical prostate cancer treatment is the predominant cause of iatrogenic stress urinary incontinence (SUI) in men, significantly impacting their quality of life (QoL). This prospective single-center study in Portugal aimed to evaluate the outcomes of men with moderate-to-severe SUI treated with a single-component artificial urinary sphincter (AUS).
Materials and methods: Male patients with iatrogenic moderate-to-severe SUI, determined by a 24-hour pad weight test, were included. The single-component device comprises a cuff linked to a pump unit through a kink-resistant tube. The implantation involved perineal incision for cuff placement and an inguinal incision for pump and tank positioning within the scrotum. Complications, pad usage, perioperative complications (Clavien-Dindo classification), and quality of life assessment using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire were documented.
Results: Between May 2021 and March 2023, 20 consecutive single-component AUS insertions were conducted at a Portuguese urology department. Follow-up concluded in July 2023, with a mean follow-up duration of 15 months (range: 5-27). Four patients experienced complications necessitating device revision or removal (erosion = 2, infection = 1, mechanical failure = 1). Social continence (0/1 pad/day) was achieved in 70% (14/20 patients), while 30% (6/20 patients) experienced incontinence. Perioperatively, one patient was classified as grade 2, while the remaining were grade 0/1 in the Clavien-Dindo classification. The mean ICIQ-SF score reduction was 10.5 points.
Conclusions: The single-component AUS shows promising efficacy in managing moderate-to-severe male SUI, offering a good success rate, acceptable complications, improved QoL, and a straightforward surgical procedure.

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How to Cite

Aragão Vital, J., Marques Monteiro, M., Lobão Teixeira, B., Grilo Mendes, G., Rocha, A., Madanelo, M., Mesquita, S., Vinagre, N., Oliveira, B., Magalhães, M., Isabel Lopes, A., Ferreira, C., Príncipe, P., & Fraga, A. (2024). Single-component artificial urinary sphincter: Outcomes from one centre in Portugal. Archivio Italiano Di Urologia E Andrologia, 96(3). https://doi.org/10.4081/aiua.2024.12661
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