Complications and Short-Term Explantation Rate Following Artificial Urinary Sphincter Implantation: Results from a Large Middle European Multi-Institutional Case Series.

Autor:	Kretschmer A; Department of Urology, Ludwig-Maximilians-University, Campus Grosshadern, Munich, Germany., Hüsch T, Thomsen F, Kronlachner D, Obaje A, Anding R, Pottek T, Rose A, Olianas R, Friedl A, Hübner W, Homberg R, Pfitzenmaier J, Grein U, Queissert F, Naumann CM, Schweiger J, Wotzka C, Nyarangi-Dix JN, Hofmann T, Seiler R, Haferkamp A, Bauer RM
Jazyk:	angličtina
Zdroj:	Urologia internationalis [Urol Int] 2016; Vol. 97 (2), pp. 205-11. Date of Electronic Publication: 2016 Jun 17.
DOI:	10.1159/000446351
Abstrakt:	Unlabelled: Background/Aims/Objectives: 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. Methods: 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). Results: 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. Conclusions: 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. (© 2016 S. Karger AG, Basel.)
Databáze:	MEDLINE
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