You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence, Evaluation & Therapy (II)1 Apr 20131047 OUTCOME AND RISK FACTOR ANALYSIS OF AMS 800 ©: A PROSPECTIVE ANALYSIS Tim Ludwig, Dahlem Roland, Luis Kluth, Philip Reiss, Silke Riechardt, Margit Fisch, and Sascha Ahyai Tim LudwigTim Ludwig Hamburg, Germany More articles by this author , Dahlem RolandDahlem Roland Hamburg, Germany More articles by this author , Luis KluthLuis Kluth Hamburg, Germany More articles by this author , Philip ReissPhilip Reiss Hamburg, Germany More articles by this author , Silke RiechardtSilke Riechardt Hamburg, Germany More articles by this author , Margit FischMargit Fisch Hamburg, Germany More articles by this author , and Sascha AhyaiSascha Ahyai Hamburg, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.633AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The artificial urinary sphincter AMS 800 has proven to be successful for control of stress urinary incontinence (SUI). However, outcome and complications of the AMS 800 are mostly published in small and out-dated case series by retrospective approaches. To address contemporary continence and complication rate we assessed our prospective AUS data base. METHODS Since 2009, we prospectively collect data for all patients who undergo AUS implantation at our tertiary center. Activation of AUS is performed 6 weeks postoperatively at our institution. Further follow-up (FU) consisting of pad test, maximal urinary flow rate (Qmax), post void residual urine, radiography, and standardized questionnaire is scheduled 6, 24 months and every two years thereafter. In this analysis, only patients with a minimum FU of 6 months were included. Primary and secondary endpoints were continence and complication rate, respectively. RESULTS A total of 105 patients with a mean FU of 22.2 months (range 6-38) were available for analyses (n=7 patients were lost to FU). At baseline mean age was 68 yrs (range 39-87). Reasons for SUI was radical prostatectomy, TURP, radical cystectomy, trauma and neurological disease in 78.1%, 17.1%, 1.9%, 1.9% and 1%, respectively. Previous incontinence surgery or pelvic irradiation therapy was observed in 25.7% and 31.4% of the patients. Comorbidities in terms of diabetes or anticoagulation therapy were found in 13.3% and 33.3%. A distal bulbar double cuff (DC) was used in 61%, a single membranous cuff (mSC) in 35.2%, a bladder neck or transcorporal AUS in 3.9%. According to PAD test 61% of all patients were completely dry. Continence rate compared favorably for the DC compared to mSC without statistically significance. During FU 16.2% patients required reoperations due to urethral erosion (5.7%), urethral atrophy (1%), mechanical failure (1.9%), and infection (3.8%). Revisions because of persistent incontinence were needed in 3.8% of the patients‘ cohort. According to Kaplan Meier analysis 85% of the implanted AMS 800 were still in place at 30 months FU. Risk factor analysis identified early wound pain at activation (Log Rank=0.019) and anticoagulation therapy (Log Rank=0.034) to be significantly associated with adverse outcome. CONCLUSIONS Our study presents midterm prospective outcome data for AMS 800. The DC seems to provide better continence than the mSC, despite concomitant adverse factors as previous incontinence treatment or irradiation therapy. Early wound pain and active anticoagulation therapy are statistically significant risk factors for reoperation. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e429 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tim Ludwig Hamburg, Germany More articles by this author Dahlem Roland Hamburg, Germany More articles by this author Luis Kluth Hamburg, Germany More articles by this author Philip Reiss Hamburg, Germany More articles by this author Silke Riechardt Hamburg, Germany More articles by this author Margit Fisch Hamburg, Germany More articles by this author Sascha Ahyai Hamburg, Germany More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...