Bersch U, Göcking K, Pannek J. The artificial urinary sphincter in patients with spinal cord lesion: description of a modified technique and clinical results.
Eur Urol 2008;
55:687-93. [PMID:
18394784 DOI:
10.1016/j.eururo.2008.03.046]
[Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Accepted: 03/18/2008] [Indexed: 11/15/2022]
Abstract
BACKGROUND
The artificial sphincter is the method of choice in patients with stress urinary incontinence due to neurogenic bladder dysfunction. However, long-term studies reveal a high revision rate.
OBJECTIVE
To determine the success and revision rates of a modified implant.
DESIGN, SETTING, AND PARTICIPANTS
In a retrospective analysis, the results of 51 consecutive patients presenting at a private paraplegic center with neurogenic bladder dysfunction (meningomyelocele: n=8; spinal cord injury: n=37; others: n=6) who underwent implantation of an artificial sphincter at the bladder neck using a port instead of a pump were evaluated.
MEASUREMENTS
Subjective and objective cure rates were assessed by video-urodynamics and a standardized interview.
RESULTS AND LIMITATIONS
After a mean follow up of 95.9 mo, 70.6% of the patients were objectively and subjectively cured; 90.2% were completely continent in everyday life. Mean bladder capacity (465 ml) and compliance (41.7 ml/cm H(2)O) were normal. Sixteen patients underwent 18 revisions (35.3%). One implant had to be permanently removed. This is a single-centre study; thus, the results have to be confirmed.
CONCLUSIONS
With a long follow up of 8 yr, the modification presented by our group proved to be highly successful, reliable, safe, and even cost-effective. Therefore, it seems to be a valuable tool for the treatment of this group of patients.
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