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Erschienen in: International Urogynecology Journal 10/2011

01.10.2011 | Original Article

Is the implantation of an artificial urinary sphincter with a large cuff in women with severe urinary incontinence associated with worse perioperative complications and functional outcomes than usual?

verfasst von: Aurélie Revaux, Morgan Rouprêt, Elise Seringe, Vincent Misraï, Florence Cour, Emmanuel Chartier-Kastler

Erschienen in: International Urogynecology Journal | Ausgabe 10/2011

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Abstract

Introduction and hypothesis

As the subsequent risks of complications and explantation increase with the size of the cuff, we aimed to assess functional outcomes after the implantation of an artificial urinary sphincter (AUS) with a large cuff (≥8 cm) in women with severe urinary incontinence.

Methods

Fifty women underwent an AUS placement with a large cuff between 1984 and 2007. Forty-three (86%) had previously undergone anti-incontinence procedures. The AUS was implanted with an open surgical technique using a transverse abdominal approach. The cuff was placed around the bladder neck between the periurethral fascia and the vagina. Perioperative complications were reviewed. To assess the resolution of urinary incontinence, all patients were seen at 1, 3, 6 and 12 months and yearly thereafter.

Results

The mean age was 59 ± 12.4 years (26–81). The mean BMI was 27.3 ± 5.1 (19–37). The mean pre-operative closure pressure was 19.1 ± 9.4 cmH2O (3–46). The mean hospital stay was 14.1 ± 5 days (5–28). The mean follow-up was 8 ± 5.6 years. Incontinence was completely resolved in 34 women (68%). The protective factors to avoid explantation were a number of gestations less than two (p = 0.04), a closure pressure higher than 19 cmH2O (p = 0.04) and a cuff size equivalent to 8 cm (p = 0.005).

Conclusions

Specific anatomical conditions can sometimes lead to AUS implantation with a large cuff with encouraging outcomes. Thus, surgeons should not be reluctant to place a large cuff when the situation requires it.
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Metadaten
Titel
Is the implantation of an artificial urinary sphincter with a large cuff in women with severe urinary incontinence associated with worse perioperative complications and functional outcomes than usual?
verfasst von
Aurélie Revaux
Morgan Rouprêt
Elise Seringe
Vincent Misraï
Florence Cour
Emmanuel Chartier-Kastler
Publikationsdatum
01.10.2011
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 10/2011
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-011-1425-0

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