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Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Perioperative Complications and Device Explantations
PURPOSE: To analyze perioperative complications and postoperative explantation rates for selected readjustable male sling systems and the perineal single-cuff artificial urinary sphincter (AUS) in a large, contemporary, multi-institutional patient cohort. METHODS: Two hundred eighty-two male patient...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Continence Society
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497191/ https://www.ncbi.nlm.nih.gov/pubmed/28673058 http://dx.doi.org/10.5213/inj.1632626.313 |
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author | Kretschmer, Alexander Hüsch, Tanja Thomsen, Frauke Kronlachner, Dominik Obaje, Alice Anding, Ralf Pottek, Tobias Rose, Achim Olianas, Roberto Friedl, Alexander Hübner, Wilhelm Homberg, Roland Pfitzenmaier, Jesco Queissert, Fabian Naumann, Carsten M. Wotzka, Carola Hofmann, Torben Seiler, Roland Haferkamp, Axel Bauer, Ricarda M. |
author_facet | Kretschmer, Alexander Hüsch, Tanja Thomsen, Frauke Kronlachner, Dominik Obaje, Alice Anding, Ralf Pottek, Tobias Rose, Achim Olianas, Roberto Friedl, Alexander Hübner, Wilhelm Homberg, Roland Pfitzenmaier, Jesco Queissert, Fabian Naumann, Carsten M. Wotzka, Carola Hofmann, Torben Seiler, Roland Haferkamp, Axel Bauer, Ricarda M. |
author_sort | Kretschmer, Alexander |
collection | PubMed |
description | PURPOSE: To analyze perioperative complications and postoperative explantation rates for selected readjustable male sling systems and the perineal single-cuff artificial urinary sphincter (AUS) in a large, contemporary, multi-institutional patient cohort. METHODS: Two hundred eighty-two male patients who underwent implantation between 2010 and 2012 in 13 participating institutions were included in the study (n=127 adjustable male sling [n=95 Argus classic, n=32 Argus T], n=155 AUS). Perioperative characteristics and postoperative complications were analyzed. The explantation rates of the respective devices were assessed using the Fisher exact test and the Mann-Whitney U-test. A Kaplan-Meier curve was generated. Potential features associated with device explantation were analyzed using a multiple logistic regression model (P<0.05). RESULTS: We found significantly increased intraoperative complication rates after adjustable male sling implantation (15.9% [adjustable male sling] vs. 4.2% [AUS], P=0.003). The most frequent intraoperative complication was bladder perforation (n=17). Postoperative infection rates did not vary significantly between the respective devices (P=0.378). Device explantation rates were significantly higher after AUS implantation (9.7% [adjustable male sling] vs. 21.5% [AUS], P=0.030). In multivariate analysis, postoperative infection was a strong independent predictor of decreased device survival (odds ratio, 6.556; P=0.001). CONCLUSIONS: Complication profiles vary between adjustable male slings and AUS. Explantation rates are lower after adjustable male sling implantation. Any kind of postoperative infections are independent predictors of decreased device survival. There is no significant effect of the experience of the implanting institution on device survival. |
format | Online Article Text |
id | pubmed-5497191 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Korean Continence Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-54971912017-07-05 Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Perioperative Complications and Device Explantations Kretschmer, Alexander Hüsch, Tanja Thomsen, Frauke Kronlachner, Dominik Obaje, Alice Anding, Ralf Pottek, Tobias Rose, Achim Olianas, Roberto Friedl, Alexander Hübner, Wilhelm Homberg, Roland Pfitzenmaier, Jesco Queissert, Fabian Naumann, Carsten M. Wotzka, Carola Hofmann, Torben Seiler, Roland Haferkamp, Axel Bauer, Ricarda M. Int Neurourol J Original Article PURPOSE: To analyze perioperative complications and postoperative explantation rates for selected readjustable male sling systems and the perineal single-cuff artificial urinary sphincter (AUS) in a large, contemporary, multi-institutional patient cohort. METHODS: Two hundred eighty-two male patients who underwent implantation between 2010 and 2012 in 13 participating institutions were included in the study (n=127 adjustable male sling [n=95 Argus classic, n=32 Argus T], n=155 AUS). Perioperative characteristics and postoperative complications were analyzed. The explantation rates of the respective devices were assessed using the Fisher exact test and the Mann-Whitney U-test. A Kaplan-Meier curve was generated. Potential features associated with device explantation were analyzed using a multiple logistic regression model (P<0.05). RESULTS: We found significantly increased intraoperative complication rates after adjustable male sling implantation (15.9% [adjustable male sling] vs. 4.2% [AUS], P=0.003). The most frequent intraoperative complication was bladder perforation (n=17). Postoperative infection rates did not vary significantly between the respective devices (P=0.378). Device explantation rates were significantly higher after AUS implantation (9.7% [adjustable male sling] vs. 21.5% [AUS], P=0.030). In multivariate analysis, postoperative infection was a strong independent predictor of decreased device survival (odds ratio, 6.556; P=0.001). CONCLUSIONS: Complication profiles vary between adjustable male slings and AUS. Explantation rates are lower after adjustable male sling implantation. Any kind of postoperative infections are independent predictors of decreased device survival. There is no significant effect of the experience of the implanting institution on device survival. Korean Continence Society 2017-06 2017-06-21 /pmc/articles/PMC5497191/ /pubmed/28673058 http://dx.doi.org/10.5213/inj.1632626.313 Text en Copyright © 2017 Korean Continence Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kretschmer, Alexander Hüsch, Tanja Thomsen, Frauke Kronlachner, Dominik Obaje, Alice Anding, Ralf Pottek, Tobias Rose, Achim Olianas, Roberto Friedl, Alexander Hübner, Wilhelm Homberg, Roland Pfitzenmaier, Jesco Queissert, Fabian Naumann, Carsten M. Wotzka, Carola Hofmann, Torben Seiler, Roland Haferkamp, Axel Bauer, Ricarda M. Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Perioperative Complications and Device Explantations |
title | Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Perioperative Complications and Device Explantations |
title_full | Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Perioperative Complications and Device Explantations |
title_fullStr | Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Perioperative Complications and Device Explantations |
title_full_unstemmed | Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Perioperative Complications and Device Explantations |
title_short | Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Perioperative Complications and Device Explantations |
title_sort | targeting moderate and severe male stress urinary incontinence with adjustable male slings and the perineal artificial urinary sphincter: focus on perioperative complications and device explantations |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497191/ https://www.ncbi.nlm.nih.gov/pubmed/28673058 http://dx.doi.org/10.5213/inj.1632626.313 |
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