Résultats à long terme du traitement de l’incontinence urinaire masculine par implantation de sphincter artificiel urinaire (AMS 800) en position bulbaire : expérience monocentrique

Abstract

To report the functional results and morbidity after implantation of bulbar artificial urinary sphincter (AUS) in incontinent men with at least 5 years of follow-up. The files of patients treated between 1984 and 2003 by setting up a SAU at bulbar location were reviewed. The following data were recorded: age, etiology of incontinence, intra-operative complications. To evaluate the results on continence, patients were seen at 1, 3, 6 and 12 months, and yearly thereafter. Overall, 159 men implanted with an AUS were included. The median age was 68.4 years and the median follow-up was 69 months. The etiology of incontinence was a prostate surgery in 83% of cases. The five-year rates of continence and satisfaction were 74.2% (n=118) and 92% (n=140), respectively. The five-year rates of infections and erosions were 4.4% and 9.4%, respectively. In case of previous radiotherapy, the rate of erosion at 5 years was 22.2%. The rate of atrophy and urethral mechanical failure at 5 years was 7.5% and 23.6%, respectively. The rate of reoperation at 5 years was 41.5%. Our results confirm that the AUS is still the standard treatment for male with urinary incontinence due to intrinsic sphincter deficiency. Minimally invasive therapies are being developed that could overcome the mechanical failures and offer an alternative in case of primary or even secondary failure of the AUS.