Comparison of adjustable continence therapy periurethral balloons and artificial urinary sphincter in female patients with stress urinary incontinence due to intrinsic sphincter deficiency

Abstract : Introduction and hypothesis - The objective was to compare the outcomes of the ACT® device with those of the artificial urinary sphincter (AUS) AMS 800 in the treatment of stress urinary incontinence (SUI) due to sphincter deficiency in women.

Methods - All the women who underwent surgical treatment for SUI due to intrinsic sphincter deficiency from 2007 to 2017 were included in a single-center retrospective study. The primary endpoint was the functional outcome. Perioperative functional parameters of the two groups were compared.

Results - Twenty-five patients underwent an ACT® implantation and 36 an AUS implantation. Patients in the AUS group were younger (62.9 vs 70.4 years; p = 0.03) with less comorbidity (ASA Score = 3 in 12.1% vs 33.3%; p = 0.005). Operative time and hospital stay were shorter in the ACT® group (45.7 vs 206.1 min; p < 0.001; 1.7 vs 7 days; p < 0.001 respectively). There was a higher rate of intraoperative complications in the AUS group (47% vs 8%; p < 0.001) but the rates of postoperative complications were similar between both groups. The ACT® was associated with an increased risk of urinary retention (20% vs 2.8%; p = 0.04). Results were in favor of AUS for: decrease in USP stress incontinence subscore (-7.6 vs -3.2; p < 0.001), number of pads per 24 h (- 4.6 vs -2.3; p = 0.002), PGII scale (PGII = 1: 61.1% vs 12%; p < 0.001), and cure rate (71.4% vs 21.7%; p < 0.001).

Conclusions - In the present series, keeping in mind the significantly different baseline characteristics, AUS implantation was associated with better functional outcomes than the ACT® in female patients with SUI due to intrinsic sphincter deficiency, but with a higher intraoperative complications rate, longer operative time, and a longer stay.

Complete list of metadatas

Cited literature [38 references]  Display  Hide  Download

https://hal-univ-rennes1.archives-ouvertes.fr/hal-01811040
Contributor : Laurent Jonchère <>
Submitted on : Monday, September 3, 2018 - 1:54:54 PM
Last modification on : Thursday, September 6, 2018 - 5:19:02 PM
Long-term archiving on : Tuesday, December 4, 2018 - 3:54:42 PM

File

Freton_Comparison of adjustabl...
Files produced by the author(s)

Identifiers

Citation

Lucas Freton, Lauranne Tondut, Isabelle Enderle, Juliette Hascoet, Andrea Manunta, et al.. Comparison of adjustable continence therapy periurethral balloons and artificial urinary sphincter in female patients with stress urinary incontinence due to intrinsic sphincter deficiency. International Urogynecology Journal, Springer Verlag, 2018, 29 (7), pp.949-957. ⟨10.1007/s00192-017-3544-8⟩. ⟨hal-01811040⟩

Share

Metrics

Record views

48

Files downloads

119