Artificial urinary sphincter implantation: outcomes evaluation in a cohort of patients beyond a ten-year follow-up

Introduction. Implantation of an artificial urinary sphincter (AUS) is the main treatment method for patients with intrinsic sphincteric deficiency. There are few studies investigating the effectiveness, safety, and impact on the quality of life of the AUS implantation beyond a ten-year follow-up. Objective. To evaluate the outcomes of the AUS implantation in terms of safety, efficacy, and impact on quality of life in a group of patients beyond a ten-year follow-up. Materials 68] years. The causes of severe stress urinary incontinence were the following interventions: radical prostatectomy — 11 patients, radical cystectomy — two patients, transurethral resection of the prostate — one patient. The median time after the intervention that caused urinary incontinence was 20 15; 26 months. The effectiveness of implantation was evaluated in 11 patients, three patients had complications preventing the use of the AUS. Median follow-up was 137 124; 160 months. There was a statistically significant decrease in the median urine loss from 700,0 600; 800 to 12,5 1; 60 ml. There was also a significant reduction in the use of pads per day from 7 7; 8 to 1 0; 2. Five patients did not use pads. Seven patients met the criterion of cure. Median IPSS-QoL scores decreased from 4 4; 5 to 2 1; 2. After treatment, the score of the ICIQ-UI SF questionnaire was 8 6; 10. Complications superior to Clavien-Dindo II were noted in 8 of 14 patients. Eight patients underwent 15 revisions, six of them repeated. The AUS was partially or completely removed in six patients. Conclusions. Over a ten-year follow-up period, a significant number of patients developed complications, including those requiring removal or replacement of the AUS or its components, and therefore patients with an AUS require regular long-term follow-up. Despite a significant proportion of patients who required an AUS revision, implantation leads to a statistically significant reduction in urine loss and an improvement in the quality of life.