Urethral instrumentation in men with artificial urinary sphincter: a national survey among Brazilian urologists.

Purpose: Urethral instrumentation (UI) in patients with an artificial urinary sphincter (AUS) demands technical considerations and poses a risk of urethral erosion, leading to serious clinical and legal consequences. We conducted a national survey to evaluate the knowledge and experience of Brazilian urologists with UI in these patients.

Methods: This study used an electronic survey distributed to members of the Brazilian Society of Urology.

Outcomes of transperineal reanastomosis as a salvage treatment for recurrent vesicourethral anastomosis stenosis after radical prostatectomy.

Purpose: To evaluate transperineal reanastomosis (TRPA) combined with incontinence surgery as a complex treatment for recurring vesicourethral anastomosis stenosis (VUAS) after radical prostatectomy (RP).

Methods: Retrospective analysis of 8 patients who underwent TRPA for recurring VUAS. Detailed preoperative and follow up data were assessed.

A new approach to repair recurrent vescicourethral anastomotic strictures after radical prostatectomy: The use of prerectal access.

Background: Vesicourethral anastomosis stenosis (VUAS) is a well-known complication of prostate cancer treatments, observed in up to 26% of the cases after radical prostatectomy. Conservative management, with single or even repeated transurethral dilation or endoscopic incision of the stenosis, is successful in many cases, but up to 9% of patients are destined to fail after endoscopic treatment. In these cases, a revision of the vesicourethral anastomosis is necessary and can be realized with different surgical approaches.

Deterioration of cystometric parameters following the artificial urinary sphincter procedure in patients with spinal cord lesion: a retrospective analysis.

Purpose: The artificial urinary sphincter (AUS) remains the gold standard to treat stress urinary incontinence related to sphincter insufficiency in patients with neurogenic lower urinary tract dysfunction (NLUTD). This study aims to assess the incidence of de novo neurogenic detrusor overactivity or low bladder compliance after AUS implantation in adult spinal cord injured patients.

Methods: Retrospective observational study, descriptive by analysis of the medical records of patients followed in a department of Neuro-Urology from January 01, 2003 to March 31, 2023.

Primary and revision artificial urinary sphincter for stress urinary incontinence post-radical prostatectomy: a surgery with high rewards but high risks?

Objectives: To evaluate the efficacy of artificial urinary sphincter (AUS) implantation in men with stress urinary incontinence post-radical prostatectomy and the complication burden with a focus on identifying potential risk factors for reoperation as well as determining the fate of revision surgeries.

Methods: Retrospective analysis of consecutive patients undergoing primary AUS (pAUS) and revision AUS (rAUS) implantation at a tertiary centre. Logistic regression was employed to identify risk factors for reoperation associated with non-mechanical failures.

Artificial urinary sphincter implantation after transperineal open reconstruction of post-prostatectomy vesicourethral anastomotic stenosis.

Purpose: This study evaluates the effectiveness of artificial urinary sphincter (AUS) implantation following transperineal reanastomosis in men with vesicourethral anastomotic stenosis (VUAS) and stress urinary incontinence (SUI) after radical prostatectomy (RP), focusing on long-term explantation rates and urinary continence.

Methods: Patients treated between 2009 and 2020 were retrospectively analyzed. Those undergoing AUS implantation post-transperineal reanastomosis for recurrent VUAS, excluding cases with prior pelvic irradiation and overactive bladder, were included.

Novel Utilization of a Penrose Drain as a Spacer During Temporary Artificial Urinary Sphincter Explantation and Rectourethral Fistula Repair.

A 65-year-old male patient with a history of external beam radiation therapy for prostate cancer and multiple urological surgeries developed a rectourethral fistula after treatment for urethral diverticulum with stones. In managing this complex case, a Penrose drain was utilized as a spacer during artificial urinary sphincter cuff removal to preserve the urethral space for future sphincter re-implantation. This report highlights the novel application of a Penrose drain as a spacer in urological surgery and its benefits in minimizing tissue contraction and preserving urethral health.

Efficacy and Safety of Artificial Urinary Sphincters in Female Patients With Stress Urinary Incontinence: A Systematic Review and Meta-Analysis.

Stress urinary incontinence (SUI) significantly affects the quality of life in women, causing social, psychological, and physical distress. While artificial urinary sphincter (AUS) implantation is a well-established treatment for male incontinence, it is less commonly used in female patients and is typically considered for cases where other treatments have failed. This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of AUS implantation in treating SUI in female patients, focusing on continence rates, revision rates, explant rates, and perioperative complications.

Determining the Severity of Benign Urologic Health States in Men Using Utilities Measures.

Objective: To assess a population-level perceived health status of common reconstructive urologic conditions using health utilities.

Methods: Health utilities are generic quality-of-life measures that can help describe overall health status and can quantitatively compare different disease states and the perceived benefits of various interventions. An a priori determined, representative sample of adult men were recruited by Qualtrics to review standardized scenarios describing typical patients with reconstructive urologic conditions, surgeries to treat conditions, and control conditions (eg, blindness, osteoarthritis).

Persistent Opioid Use Following Artificial Urinary Sphincter Placement: A Large Claims Database Analysis.

Objective: To assess risk of persistent opioid use and emergency department (ED) and office/outpatient visits following post-operative prescriptions of common opioids in patients following artificial urinary sphincter (AUS) implantation using a nationwide claims database.

Methods: The TriNetX US Collaborative Network, which encompasses over 115 million patients from 66 healthcare organizations was used to identify males who underwent first-time AUS placement between 2010-2024. Patients with history of opioid dependence/abuse, opioid use within 6 months prior to AUS placement, or surgery within 9 months post-operation were excluded.

Artificial Urinary Sphincter Implants in Men: A National Health Care Data System-Based Study to Assess Reinterventions in France.

Purpose: Significant concerns remain regarding the long-term outcomes of AMS 800 artificial urinary sphincter (AUS) implants in men. The objective was to assess the long-term AUS reintervention (replacement or removal) rates after a first-ever AUS implantation.

Materials And Methods: This population-based retrospective cohort study included all men age ≥ 18 years in France who underwent a first-ever AUS implantation (identified using a unique device identifier) for male stress urinary incontinence (SUI) after prostate cancer (PCa) or benign prostatic hyperplasia (BPH) treatment, between January 1, 2006, and December 31, 2018.

Long-term results of artificial urinary sphincter in women: A retrospective monocentric study.

Background: Stress urinary incontinence (SUI) is a public health issue, with major impact on quality of life. An efficient treatment for intrinsic sphincter deficiency (ISD) is the artificial urinary sphincter (AUS).

Objectives: Analyzing patient survival in terms of revision-free survival, removal-free survival and global survival without reintervention long-term results concerning continence status and complications.

Robotic female artificial urinary sphincter implantation vs. male artificial urinary sphincter implantation for non-neurogenic stress urinary incontinence.

Purpose: Previous studies suggested better functional outcomes and longer device survival for female artificial urinary sphincter (AUS) implantation compared to male AUS implantation. We hypothesized that the adoption of robotic approaches for female implantation might have influenced these comparisons. This study aimed to compare the outcomes of robotic female AUS and male AUS implantation for non-neurogenic stress urinary incontinence (SUI).