Artificial urinary sphincter implantation in the irradiated patient: Safety, efficacy and satisfaction

I. K. Walsh, S. G. Williams, V. Mahendra, T. Nambirajan, Anthony R Stone

Research output: Contribution to journalArticle

95 Scopus citations

Abstract

Objective: To compare the long-term outcome of artificial urinary sphincter (AUS) implantation in patients after prostatectomy, with and with no history of previous irradiation. Patients and methods: The study included 98 men (mean age 68 years) with urinary incontinence after prostatectomy for prostate cancer (85 radical, 13 transurethral resection) who had an AUS implanted. Twenty-two of the patients had received adjuvant external beam irradiation before AUS implantation. Over a mean (range) follow-up of 46 (5-118) months, the complication and surgical revision rates were recorded and compared between irradiated and unirradiated patients. The two groups were also compared for the resolution of incontinence and satisfaction, assessed using a questionnaire. Results: Overall, surgical revision was equally common in irradiated (36%) and unirradiated (24%) patients. After activating the AUS, urethral atrophy, infection and erosion requiring surgical revision were more common in irradiated patients (41% vs 11%; P < 0.05); 70% of patients reported a significant improvement in continence, regardless of previous irradiation. Patient satisfaction remained high, with > 80% of patients stating that they would undergo surgery again and/or recommend it to others, despite previous irradiation and/or the need for surgical revision. Conclusions: Despite higher complication and surgical revision rates in patients who have an AUS implanted and have a history of previous irradiation, the long-term continence and patient satisfaction appear not to be adversely affected.

Original languageEnglish (US)
Pages (from-to)364-368
Number of pages5
JournalBJU International
Volume89
Issue number4
DOIs
StatePublished - 2002

Keywords

  • Artificial urinary sphincter
  • Outcome
  • Prostatectomy
  • Radiotherapy
  • Urinary incontinence

ASJC Scopus subject areas

  • Urology

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