Factors affecting the success and complications of artificial urinary sphincter implantation and our long-term outcomes (25 years of experience)

Objective: In this study we investigated the factors affecting both our success and complication rates in patients undergone artificial urinary sphincter (AUS) implantation and our long-term results. Material and Methods: Data from 82 patients which were performed a total of 97 AUS implantation (including 13 recurrent patients; 2 were performed 3 times and 11 were performed 2 times) in Urology Clinic of Ankara D？skap？ Training and Research Hospital between the years 1990 and 2015 were analyzed retrospectively. Degree and amount of incontinence and quality of life were evaluated by International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI SF), pad test and the 5th question in ICIQ-UI SF, respectively. Mean age of our patients were 66.2 (15-79) years while mean follow-up period was 76 (6-300) months. Two groups were composed as AUS implantation one time and recurrent times and the results were compared. Results: Of our AUS implantated patients, we noticed complete dryness in 57 (69.5%), social continence in 15(18.2%) and incontinence in 10 (12.1%). Of the 13 recurrent patients, we noticed complete dryness in 5 (38.4%), social continence in 5 (38.4%) an incontinence in 3 (23.07%). When compared; symptom score, amount of incontinence and quality of life score results seemed to be better in the 1 time AUS performed group than the recurrent group, but it was not statistically significant. Complication rate was 20.7% including infection and/or cuff erosion in 12 patients and mechanical failure in 5 patients. Conclusion: AUS is the most effective treatment method of incontinence in appropriate patients. We believe that it may be preferable by considering cost analysis and revision and re-implantation facilities in terms of being a safe and economical procedure