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25.07.2019 | Original Article | Ausgabe 5/2020

World Journal of Urology 5/2020

Determinants and prognostic value of post-operative maximum urethral closure pressure after artificial urinary sphincter in men

Zeitschrift:
World Journal of Urology > Ausgabe 5/2020
Autoren:
Imad Bentellis, Mehdi El-Akri, Juliette Hascoet, Quentin Alimi, Romain Mathieu, Sébastien Vincendeau, Jacques Kerdraon, Caroline Voiry, Andrea Manunta, Benoit Peyronnet
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Abstract

Purpose

To evaluate the determinants and prognostic value of post-operative maximum urethral closure pressure (MUCP) after AUS implantation in male patients.

Methods

The charts of all male patients who had an AUS implantation between 2008 and 2018 at a single center were reviewed retrospectively for an exploratory study. A post-operative urethral profilometry was performed systematically as part of routine daily practice over the study period to assess the post-operative MUCP with the AUS consecutively closed (c-MUCP) and opened (o-MUCP). The difference between c-MUCP and the manufacturer’s theoretical pressure objective determined by the pressure regulating balloon (PRB) was calculated (diff-th-MUCP). The primary endpoint was social continence at 3 months defined as 0–1 protection/day.

Results

Ninety patients were included. The median age was 71 years, and the median follow-up was 50 months. The etiology of incontinence was radical prostatectomy in 84% of cases, and endoscopic prostate surgery in 6.6% of patients. There were 74.4% of patients who were socially continent at 3 months. The c-MCUP was significantly higher in the continent group (53 [42.2, 60.2] vs 62 [58, 70] p = 0.02). The diff-th-MUCP did not differ significantly between the two groups (18 [0, 23] vs 1 [− 2, 7.7] p = 0.29). The c-MUCP was not statistically associated with the risk of revision and/or explantation.

Conclusion

The MUCP after AUS implantation in male patients often differs from the manufacturer’s pressure objective. The postoperative c-MUCP might be significantly associated with functional outcomes suggesting that it might be a valuable tool for treatment decision-making. This should be confirmed by larger studies.

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