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Complications and short-term explantation rate following artificial urinary sphincter implantation: results from a large middle european multi-institutional case series

<b><i>Background/Aims/Objectives:</i></b> To analyze perioperative complication and short-term explantation rates after perineal or penoscrotal single-cuff and double-cuff artificial urinary sphincter (AUS) implantation in a large middle European multi-institutional patient c...

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Main Authors: Kretschmer, Alexander (Author) , Hüsch, Tanja (Author) , Thomsen, Frauke (Author) , Kronlachner, Dominik (Author) , Obaje, Alice (Author) , Anding, Ralf (Author) , Pottek, Tobias (Author) , Rose, Achim (Author) , Olianas, Roberto (Author) , Friedl, Alexander (Author) , Hübner, Wilhelm (Author) , Homberg, Roland (Author) , Pfitzenmaier, Jesco (Author) , Grein, Ulrich (Author) , Queissert, Fabian (Author) , Naumann, Carsten Maik (Author) , Schweiger, Josef (Author) , Wotzka, Carola (Author) , Nyarangi-Dix, Joanne (Author) , Hofmann, Torben (Author) , Seiler, Roland (Author) , Haferkamp, Axel (Author) , Bauer, Ricarda M. (Author) , Incontinence (DOMINO)-Project, Debates On Male (Author)
Format: Article (Journal)
Language:English
Published: June 17, 2016
In: Urologia internationalis
Year: 2016, Volume: 97, Issue: 2, Pages: 205-211
ISSN:1423-0399
DOI:10.1159/000446351
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1159/000446351
Verlag, lizenzpflichtig, Volltext: https://www.karger.com/Article/FullText/446351
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Author Notes:Alexander Kretschmer, Tanja Hüsch, Frauke Thomsen, Dominik Kronlachner, Alice Obaje, Ralf Anding, Tobias Pottek, Achim Rose, Roberto Olianas, Alexander Friedl, Wilhelm Hübner, Roland Homberg, Jesco Pfitzenmaier, Ulrich Grein, Fabian Queissert, Carsten Maik Naumann, Josef Schweiger, Carola Wotzka, Joanne N. Nyarangi-Dix, Torben Hofmann, Roland Seiler, Axel Haferkamp, Ricarda M. Bauer, Debates On Male Incontinence (DOMINO)-Project
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Summary:<b><i>Background/Aims/Objectives:</i></b> To analyze perioperative complication and short-term explantation rates after perineal or penoscrotal single-cuff and double-cuff artificial urinary sphincter (AUS) implantation in a large middle European multi-institutional patient cohort. <b><i>Methods:</i></b> 467 male patients with stress urinary incontinence underwent implantation of a perineal single-cuff (n = 152), penoscrotal single-cuff (n = 99), or perineal double-cuff (n = 216) AUS between 2010 and 2012. Postoperative complications and 6-month explantation rates were assessed. For statistical analysis, Fisher's exact test and Kruskal-Wallis rank sum test, and a multiple logistic regression model were used (p < 0.05). <b><i>Results:</i></b> Compared to perineal single-cuff AUS, penoscrotal single-cuff implantation led to significantly increased short-term explantation rates (8.6% (perineal) vs. 19.2% (penoscrotal), p = 0.019). The postoperative infection rate was significantly higher after double-cuff compared to single-cuff implantation (6.0% (single-cuff) vs. 13.9% (double-cuff), p = 0.019). The short-term explantation rate after primary double-cuff placement was 6.5% (p = 0.543 vs. perineal single-cuff). In multivariate analysis, the penoscrotal approach (p = 0.004), intraoperative complications (p = 0.005), postoperative bleeding (p = 0.011), and perioperative infection (p < 0.001) were independent risk factors for short-term explantation. <b><i>Conclusions:</i></b> Providing data from a large contemporary multi-institutional patient cohort from high-volume and low-volume institutions, our results reflect the current standard of care in middle Europe. We indicate that the penoscrotal approach is an independent risk factor for increased short-term explantation rates.
Item Description:Gesehen am 27.05.2020
Physical Description:Online Resource
ISSN:1423-0399
DOI:10.1159/000446351

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