Artificial Urinary Sphincter Placement in Elderly Men

Abstract

Objectives To evaluate the outcomes of primary artificial urinary sphincter (AUS) placement for the treatment of postprostatectomy stress urinary incontinence in patients aged 75 years or older at surgery. Methods From September 1987 through June 2005, 33 men aged 75 years or older underwent AUS insertion for postprostatectomy stress urinary incontinence. Through retrospective chart review and personal/family interview, the patients’ outcomes with regard to continence, complications, and the need to deactivate the AUS for medical or social reasons were determined. Results Four patients were lost to follow-up and were excluded from the analysis. The mean patient age was 77.6 years (range 75 to 83). The average follow-up was 5.0 years (range 1 to 11). After AUS insertion, the mean pad use improved from 6.7 (range 3 to 10) to 0.8 (range 0 to 2) per day. Overall, 16 (55%) of 29 men reported no complications. AUS revision was necessary in 4 men (14%), and sphincter removal in 4 (14%). Six men (21%) required deactivation of the implant because of poor overall health an average of 47 months after placement. The “success” rate improved to 72% (21 of 29 men) when cuff deactivation without revision or removal was not considered a complication. Conclusions In our study, elderly men did well after AUS placement for postprostatectomy stress urinary incontinence. The procedure should not be withheld solely on the basis of the age of the patient.