Post-prostatectomy incontinence and the artificial urinary sphincter: A long-term study of patient satisfaction and criteria for success

Scott E. Litwiller, Kap B. Kim, Patricia D. Fone, Ralph W deVere White, Anthony R Stone

Research output: Contribution to journalArticle

175 Citations (Scopus)

Abstract

Purpose: We investigated patient satisfaction with the artificial urinary sphincter and established criteria for a successful outcome by inquiring about patient perceived satisfaction, continence achieved and comparison with the surgeon office records. Materials and Methods: During 9 years 65 patients with post-prostatectomy incontinence underwent placement of the AMS800 artificial urinary sphincter. Review of charts and a telephone questionnaire were conducted to determine patient perceived satisfaction. Results: A total of 50 patients participated in the survey. Median followup was 23.4 months. Preoperative incontinence was severe. Of the patients 90% reported continuous leakage, and 70% wore an average of 6 diapers and 24% wore an average of 7.4 pads daily. The long-term complete continence rate was 20%. Of the patients with wetness 55% had leakage of a few drops daily and 22% had leakage of less than a teaspoon. Of all patients 50% had leakage daily, 24% had leakage 1 or more times a week and wore an average of 1.5 pads per day, and 6% reported changing clothes due to wetness. A total of 90% of the patients reported satisfaction with the artificial urinary sphincter and 96% stated that they would recommend or had recommended the artificial urinary sphincter to a friend. In retrospect, 92% of the patients would have the artificial urinary sphincter placed again, 90% of those undergoing revision reported no change in satisfaction and 14% reported improved sexual activity. Conclusions: Patient satisfaction with the artificial urinary sphincter for post-prostatectomy incontinence is uniformly high. Although postoperative continence was not 100%, relative improvement in continence was the most significant factor affecting patient perceived outcome. Using these parameters criteria for a successful outcome can be established, and patient concerns regarding the artificial urinary sphincter can be dispelled.

Original languageEnglish (US)
Pages (from-to)1975-1980
Number of pages6
JournalJournal of Urology
Volume156
Issue number6
DOIs
StatePublished - Dec 1996

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Artificial Urinary Sphincter
Prostatectomy
Patient Satisfaction
Clothing
Telephone
Sexual Behavior

Keywords

  • artificial organs
  • prostatectomy
  • urinary incontinence

ASJC Scopus subject areas

  • Urology

Cite this

Post-prostatectomy incontinence and the artificial urinary sphincter : A long-term study of patient satisfaction and criteria for success. / Litwiller, Scott E.; Kim, Kap B.; Fone, Patricia D.; deVere White, Ralph W; Stone, Anthony R.

In: Journal of Urology, Vol. 156, No. 6, 12.1996, p. 1975-1980.

Research output: Contribution to journalArticle

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abstract = "Purpose: We investigated patient satisfaction with the artificial urinary sphincter and established criteria for a successful outcome by inquiring about patient perceived satisfaction, continence achieved and comparison with the surgeon office records. Materials and Methods: During 9 years 65 patients with post-prostatectomy incontinence underwent placement of the AMS800 artificial urinary sphincter. Review of charts and a telephone questionnaire were conducted to determine patient perceived satisfaction. Results: A total of 50 patients participated in the survey. Median followup was 23.4 months. Preoperative incontinence was severe. Of the patients 90{\%} reported continuous leakage, and 70{\%} wore an average of 6 diapers and 24{\%} wore an average of 7.4 pads daily. The long-term complete continence rate was 20{\%}. Of the patients with wetness 55{\%} had leakage of a few drops daily and 22{\%} had leakage of less than a teaspoon. Of all patients 50{\%} had leakage daily, 24{\%} had leakage 1 or more times a week and wore an average of 1.5 pads per day, and 6{\%} reported changing clothes due to wetness. A total of 90{\%} of the patients reported satisfaction with the artificial urinary sphincter and 96{\%} stated that they would recommend or had recommended the artificial urinary sphincter to a friend. In retrospect, 92{\%} of the patients would have the artificial urinary sphincter placed again, 90{\%} of those undergoing revision reported no change in satisfaction and 14{\%} reported improved sexual activity. Conclusions: Patient satisfaction with the artificial urinary sphincter for post-prostatectomy incontinence is uniformly high. Although postoperative continence was not 100{\%}, relative improvement in continence was the most significant factor affecting patient perceived outcome. Using these parameters criteria for a successful outcome can be established, and patient concerns regarding the artificial urinary sphincter can be dispelled.",
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