Efficacy and safety of the ZSI375 artificial urinary sphincter for male stress urinary incontinence: lessons learned

PurposeTo analyze efficacy and safety for the ZSI375 artificial urinary sphincter in a multicenter case series.MethodsThirteen male patients with stress urinary incontinence underwent implantation of a ZSI375 artificial urinary sphincter device between 2010 and 2012 in three international continence...

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Main Authors: Kretschmer, Alexander (Author) , Nyarangi-Dix, Joanne (Author)
Format: Article (Journal)
Language:English
Published: 25 February 2016
In: World journal of urology
Year: 2016, Volume: 34, Issue: 10, Pages: 1457-1463
ISSN:1433-8726
DOI:10.1007/s00345-016-1787-5
Online Access:Verlag, Volltext: http://dx.doi.org/10.1007/s00345-016-1787-5
Verlag, Volltext: https://link.springer.com/article/10.1007/s00345-016-1787-5
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Author Notes:Alexander Kretschmer, Tanja Hüsch, Frauke Thomsen, Dominik Kronlachner, Tobias Pottek, Alice Obaje, Ralf Anding, Achim Rose, Roberto Olianas, Alexander Friedl, Wilhelm Hübner, Roland Homberg, Jesco Pfitzenmaier, Ulrich Grein, Fabian Queissert, Carsten M. Naumann, Josef Schweiger, Carola Wotzka, Joanne N. Nyarangi-Dix, Torben Hofmann, Alexander Buchner, Axel Haferkamp, Ricarda M. Bauer, Debates On Male Incontinence (DOMINO)-Project
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Summary:PurposeTo analyze efficacy and safety for the ZSI375 artificial urinary sphincter in a multicenter case series.MethodsThirteen male patients with stress urinary incontinence underwent implantation of a ZSI375 artificial urinary sphincter device between 2010 and 2012 in three international continence reference centers. Perioperative characteristics and postoperative complications were analyzed using the Clavien-Dindo scale. Re-hospitalization and explantation rates, and functional outcome were assessed. Inner-group and between-group differences were analyzed using Wilcoxon, Mann-Whitney U, and Fisher’s exact test whenever indicated. Kaplan-Meier analysis was performed to assess device survival. A p value below 0.05 was considered statistically significant.ResultsThere were no intraoperative complications. Median follow-up was 13.5 months. In this period, four device defects (30.8 %) could be observed, being the main cause for device explantation, followed by device infection (15.4 %), non-resolvable pain (7.7 %), and urethral erosion (7.7 %). There were no Clavien IV or Clavien V complications. Overall explantation rate was 61.5 %. Mean time-to-explantation was 279 ± 308 days. There was no significant influence of previous irradiation and previous invasive incontinence therapy (p = 0.587 and p = 0.685, respectively). Mean daily pad usage decreased from 5.8 ± 1.5 to 2.4 ± 2.1 (p = 0.066). One patient (7.7 %) did not use any pads. Social continence (0-1 pads) was achieved in 15.4 % of the patients.ConclusionThis is the most current study that is investigating the outcome after ZSI375 implantation in a multicenter case series. Based on our results, explantation rates after ZSI375 implantation are high and efficacy rates seem lower than previously described. Addressing this high failure rate, the system has undergone a two-step modification in the meantime.
Item Description:Im Titel ist "375" in ZSI375 tiefgestellt
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Physical Description:Online Resource
ISSN:1433-8726
DOI:10.1007/s00345-016-1787-5