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Ducrot Q, Brierre T, Roulette P, Soulié M, Castel-Lacanal E, Gamé X. [Sacral neuromodulation for bladder voiding dysfunction: Experience at a French university center]. Prog Urol 2023; 33:1062-1072. [PMID: 37739836 DOI: 10.1016/j.purol.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/21/2023] [Accepted: 09/03/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE To report the experience of a university hospital center with sacral neuromodulation for patients with bladder voiding disorders. MATERIAL AND METHODS All patients who underwent sacral neuromodulation between 1998 and 2022 for bladder voiding disorders were included. Medical records were analyzed retrospectively, and population, efficacy and follow-up data were collected. RESULTS A total of 134 patients underwent test implantation and 122 patients were analyzed. 68 patients (56%) were implanted with a definitive neuromodulation device. Mean age was 43±16 years and BMI 25.5±5.4kg/m2. 74% were women. Bladder voiding disorder was due to sphincter hypertonia in 51% of cases, with associated bladder hypocontractility in 29%. The spontaneous micturition rate after implantation increased from 34% to 92%. Implantation results appeared to be better in patients with sphincter hypertonia, whether or not associated with bladder hypocontractility. The benefit was most often present with a frequency of 5Hz (54.4%). Side-effects were present in 52% of cases at 5 years, and in 85% of cases were pain in relation to the implanted devices. They resolved under medical treatment or after revision of the device (27% of cases at 5 years). CONCLUSION SNM is effective in micturition recovery, but has side effects. Urodynamic mechanism and etiology may provide clues for modulating NMS box settings and determining predictive factors for NMS success. Data from other centers are needed to identify reliable predictive factors.
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Affiliation(s)
- Q Ducrot
- Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA50032, 31059 Toulouse cedex, France.
| | - T Brierre
- Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA50032, 31059 Toulouse cedex, France
| | - P Roulette
- Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA50032, 31059 Toulouse cedex, France
| | - M Soulié
- Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA50032, 31059 Toulouse cedex, France
| | - E Castel-Lacanal
- Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA50032, 31059 Toulouse cedex, France
| | - X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA50032, 31059 Toulouse cedex, France
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Girard C, El-Akri M, Durand M, Guérin O, Rambaud C, Cornu J, Brierre T, Cousin T, Gaillard V, Tricard T, Dupuis H, Hermieu N, Bertrand-Leon P, Chevallier D, Bruyere F, Biardeau X, Hermieu J, Lecoanet P, Capon G, Game X, Saussine C, Peyronnet B, Bentellis I. Efficacy, safety and reoperation-free survival of artificial urinary sphincter in non neurological male patients over 75 years of age. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00819-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Peyronnet B, Cousin T, Bentellis I, Lasri S, Taha F, Hermieu N, Boileau A, Zelmar A, Ciolek C, Dubois A, Leon P, Hermieu J, Brierre T, Gamé X, Tricard T, Saussine C, Lecoanet P, Vidart A, Bruyère F, Cornu JN, Biardeau X, Capon G. Which revision strategy is the best in case of non-mechanical failure of male artificial urinary sphincter? A multicenter study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00818-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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El Akri M, Bentellis I, Tricard T, Brierre T, Cousin T, Dupuis H, Hermieu N, Gaillard V, Poussot B, Robin D, Pitout A, Bertrand-Leon P, Chevallier D, Bruyere F, Biardeau X, Monsaint H, Corbel L, Saussine C, Hermieu J, Lecoanet P, Capon G, Cornu JN, Game X, Ruffion A, Peyronnet B. Transcorporal vs. bulbar artificial urinary sphincter implantation in male patients with fragile urethra. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00664-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Robin D, Peyronnet B, Bentellis I, El-Akri M, Cornu JN, Brierre T, Cousin T, Gaillard V, Poussot B, Dupuis H, Tricard T, Hermieu N, Pitout A, Beraud F, Chevallier D, Bruyere F, Biardeau X, Monsaint H, Corbel L, Hermieu JF, Lecoanet P, Capon G, Saussine C, Gamé X, Léon P. Sphincter urinaire artificiel chez les patients présentant une incontinence urinaire après High Intensivity Focused Ultrasound Therapy. Prog Urol 2022; 32:284-290. [DOI: 10.1016/j.purol.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
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Brierre T, Roumiguie M, Soulie M, Rischmann P, Thoulouzan M, Game X. [Comparison of penoscrotal and perineal approaches for implantation of an artificial urinary sphincter in man]. Prog Urol 2021; 31:1182-1191. [PMID: 34801387 DOI: 10.1016/j.purol.2021.08.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Artificial urinary sphincter is considered the gold standard of treatment for male urinary incontinence because of intrinsic sphincter deficiency. The objective of our study was to compare the functional results and complications of the penoscrotal and perineal incision for the implantation of artificial urinary sphincter. MATERIAL AND METHODS A retrospective, monocentric study comparing the perioperative and long-term results of primary implantation of an artificial urinary sphincter in men, performed by the penoscrotal or the perineal incision, was conducted in a French university hospital. RESULTS Between April 2004 and February 2019, 175 patients were implanted (118 by penoscrotal incision and 57 by perineal incision) by 19 surgeons. Cuff placement approach depended on surgeon preference. The average follow-up was 34.2 ± 35.6 months. Cuff size was smaller in the penoscrotal group (4 [4;5] vs 4.5[4;5] p<0.001). At the end of follow-up, the rates of complete continence, social continence, reintervention for any reason, explantation, and revision was similar between the two groups. CONCLUSION Long-term outcomes of penoscrotal and perineal artificial sphincter implantation were similar between the two groups. Prospective multicenter studies are needed to confirm these results.
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Affiliation(s)
- T Brierre
- Département d'Urologie, Transplantation Rénale et Andrologie, CHU Rangueil, TSA 50032, 31059 Toulouse, France.
| | - M Roumiguie
- Département d'Urologie, Transplantation Rénale et Andrologie, CHU Rangueil, TSA 50032, 31059 Toulouse, France
| | - M Soulie
- Département d'Urologie, Transplantation Rénale et Andrologie, CHU Rangueil, TSA 50032, 31059 Toulouse, France
| | - P Rischmann
- Département d'Urologie, Transplantation Rénale et Andrologie, CHU Rangueil, TSA 50032, 31059 Toulouse, France
| | - M Thoulouzan
- Département d'Urologie, Transplantation Rénale et Andrologie, CHU Rangueil, TSA 50032, 31059 Toulouse, France
| | - X Game
- Département d'Urologie, Transplantation Rénale et Andrologie, CHU Rangueil, TSA 50032, 31059 Toulouse, France
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Bentellis I, El-Akri M, Cornu JN, Brierre T, Cousin T, Gaillard V, Poussot B, Dupuis H, Hermieu N, Robin D, Pitout A, Beraud F, Bertrand-Leon P, Chevallier D, Bruyere F, Biardeau X, Monsaint H, Corbel L, Hermieu JF, Lecoanet P, Capon G, Game X, Saussine C, Durand M, Peyronnet B. Impact of the center volume activity on the results of artificial urinary sphincter in non-neurological male patients. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00506-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bentellis I, El-Akri M, Cornu J, Brierre T, Cousin T, Gaillard V, Poussot B, Dupuis H, Hermieu N, Robin D, Pitout A, Beraud F, Bertrand-Leon P, Chevallier D, Bruyere F, Biardeau X, Monsaint H, Corbel L, Hermieu J, Lecoanet P, Capon G, Game X, Saussine C, Durand M, Peyronnet B. Prevalence and risk factors of artificial urinary sphincter revision in non-neurological male patients. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00507-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bajeot AS, Brierre T, Beauval JB, Roulette P, Bordier B, Zgheib J, Huyghe É, Soulié M, Roumiguié M, Gamé X. [Survival analysis of adjustable continence therapy device (ACT®/proACT®): a new message for patients]. Prog Urol 2020; 31:215-222. [PMID: 33339737 DOI: 10.1016/j.purol.2020.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 09/18/2020] [Accepted: 10/15/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The main purpose was to assess the failure free survival of adjustable continence therapy ACT®/proACT® after continence was obtained and to seek factors influencing it. MATERIAL AND METHODS Retrospective, single-center survival study of peri-urethral balloons implanted between 2007 and 2014. Efficacy was defined by the wearing of 0 or 1 safety pad per day. The primary end point was time to failure estimated from a survival curve (Kaplan-Meier). Factors that could influence failure free survival were: sex, age, radiotherapy, diabetes, number of pad before surgery, number of balloon inflation, early complications, mixed urinary incontinence and previous ACT®/proACT® placement. They were analyzed in a COX regression. RESULTS Of the 82 peri-urethral balloons placed, 41 were effective in 36 patients. The failure free survival was 50 % at 60 months. Radiotherapy, diabetes and previous peri-urethral balloon placement appeared to significantly decrease survival (P=0.031;P=0.025;P=0.029, respectively). Fifteen peri-urethral balloons were still effective at the last follow-up, one was lost to follow-up and 25 required re-intervention for loss of efficacy. The main cause of efficacy loss was system leakage. Fifty-two percent of peri-urethral balloons that became ineffective were replaced by new peri-urethral balloons and 28% by an artificial urinary sphincter. CONCLUSION Patients who became continent with adjustable continence therapy (ACT®/proACT®) had a 50 % new surgery probability at 5 years for a loss of efficacy. Radiotherapy seems to be the main risk factor of the efficacy loss. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- A-S Bajeot
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier Toulouse III, TSA50032, 31059 Toulouse, France.
| | - T Brierre
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier Toulouse III, TSA50032, 31059 Toulouse, France
| | - J-B Beauval
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier Toulouse III, TSA50032, 31059 Toulouse, France
| | - P Roulette
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier Toulouse III, TSA50032, 31059 Toulouse, France
| | - B Bordier
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier Toulouse III, TSA50032, 31059 Toulouse, France
| | - J Zgheib
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier Toulouse III, TSA50032, 31059 Toulouse, France
| | - É Huyghe
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier Toulouse III, TSA50032, 31059 Toulouse, France
| | - M Soulié
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier Toulouse III, TSA50032, 31059 Toulouse, France
| | - M Roumiguié
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier Toulouse III, TSA50032, 31059 Toulouse, France
| | - X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, université Paul-Sabatier Toulouse III, TSA50032, 31059 Toulouse, France
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El-Akri M, Bentellis I, Tricard T, Brierre T, Cousin T, Depuis H, Hermieu N, Robin D, Poussot B, Bertrand P, Chevallier D, Bruyère F, Saussine C, Lecoanet P, Capon G, Hermieu J, Cornu J, Gamé X, Ruffion A, Peyronnet B. Comparaison de l’implantation transcaverneuse d’un sphincter artificiel urinaire artificiel en primo-implantation vs en réimplantation. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bentellis I, El-Akri M, Tricard T, Brierre T, Cousin T, Dupuis H, Hermieu N, Poussot B, Pitout A, Bertrand-Léon P, Chevallier D, Bruyère F, Saussine C, Hermieu J, Lecouanet P, Ruffion A, Capon G, Cornu J, Gamé X, Peyronnet B. Facteurs de risque de révision de sphincter urinaire artificiel chez l’homme selon la cause. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gamé X, Doumerc N, Capronnier O, Gougeon A, Pignier C, Brierre T. [Knowledge, practices and expectations in the management of overactive bladder in general practice and gynecology in France]. Prog Urol 2020; 30:675-683. [PMID: 32684496 DOI: 10.1016/j.purol.2020.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 04/10/2020] [Accepted: 04/14/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Overactive bladder (OAB) is a clinical syndrome characterized by urgency to urinate, with or without urinary incontinence, often associated with nycturia and pollakiuria. The aim of this practice survey is to identify diagnostic modalities and treatment circuits according to the patient's clinical profile and to practitioner's specialty. MATERIAL AND METHODS A cross-sectional survey was conducted among 262 physicians practicing in France: 181 general practitioners (GPs) and 81 gynecologists. RESULTS Urinary disorders were more easily addressed with patients by gynecologists than GPs. Behavioral therapy was the most widely used therapeutic measure, however half of the patients abandoned it. In oldest women and men of all ages, drugs were commonly prescribed, nevertheless only 4 out of 10 patients continued the treatment beyond 6months, according to the physicians. Incontinence was the symptom for which patients were in most need of relief. GPs and gynecologists expressed a need for training, practical tools and recommendations related to OAB. CONCLUSION Patients and doctors are reluctant to talk about urinary disorders. Non-urologist physicians such as GPs and gynecologists, as health professionals best placed to detect and diagnose OAB, are in demand for training, practical tools and recommendations. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, TSA 50032, 31059 Toulouse, France.
| | - N Doumerc
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, TSA 50032, 31059 Toulouse, France
| | | | - A Gougeon
- Euraxi Pharma, 37300 Joué-lès-Tours, France
| | - C Pignier
- Pierre Fabre médicament, direction médicale, 81106 Castres cedex, France
| | - T Brierre
- Département d'urologie, transplantation rénale et andrologie, CHU de Rangueil, TSA 50032, 31059 Toulouse, France
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Encatassamy F, Hascoët J, Brierre T, Manunta A, Le Normand L, Gamé X, Peyronnet B, Perrouin-Verbe MA. Robot-assisted bladder neck artificial urinary sphincter implantation in male patients with neurogenic stress urinary incontinence: A multicenter study. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/s1569-9056(19)30762-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Brierre T, Guilloteau V, Guardia M, Valéra M, Foidart J, Arnal J, Lluel P, Soulie M, Gamé X. Effets fonctionnels de l’estétrol (e4) sur le bas appareil urinaire de la souris ovariectomisée. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Beauval J, Roumiguié M, Benoit T, Peyronnet B, Verhoest G, Brierre T, Thoulouzan M, Rischmann P, Soulié M, Bensalah K, Doumerc N. Évolution de la néphrectomie au profit de la néphrectomie partielle robot-assistée au cours du temps : étude bicentrique. Prog Urol 2015; 25:820. [DOI: 10.1016/j.purol.2015.08.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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