CLINICAL EXPERIENCE WITH THE ARTIFICIAL URINARY SPHINCTER AMS 800 FOR MALE INCONTINENCE
| Autor: | Jun Kurokawa, Ken Koshiba, Mikio Nagata, Asako Ohkawa, Setsuo Mashimo, Norio Maru, Junnosuke Fukui, Eiji Yokoyama, Awato Fujino, Toyoaki Uchida |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Urology medicine.medical_treatment Periprosthetic Urinary incontinence Vesicoureteral reflux Artificial urinary sphincter Postoperative Complications Humans Medicine Overflow incontinence Aged Prostatectomy business.industry Prostheses and Implants Middle Aged medicine.disease Surgery Neck of urinary bladder Urinary Incontinence Urethra medicine.anatomical_structure medicine.symptom business Radical retropubic prostatectomy |
| Zdroj: | The Japanese Journal of Urology. 86:1770-1775 |
| ISSN: | 1884-7110 0021-5287 |
| DOI: | 10.5980/jpnjurol1989.86.1770 |
| Popis: | BACKGROUND The aim of this study is to evaluate the therapeutic efficacy of artificial urinary sphincter AMS 800 implants for male patients with urinary incontinence. METHODS Eleven male patients with urinary incontinence were treated by implantation of the artificial urinary sphincter AMS 800 between 1988 and 1992. Patient age at the surgery ranged from 14 to 79 years, with a mean age of 58 years. At presentation, 9 patients (82%) had true incontinence and 2 had overflow incontinence, and medical treatments and/or surgical procedures (Teflon injections in 2 and Sling procedure in 1) had been attempted previously elsewhere in all patients. The etiologies of incontinence were post-prostatectomy (transurethral resection in 4 and radical retropubic prostatectomy in 4) in 8 patients (73%) and myelomeningocele, spinal cord injury, pelvic trauma in one each. There were 5 patients with abnormal cystometrogram, and 2 of them were performing intermittent self catheterization. Vesicoureteral reflux was determined in 2 patients preoperatively, which were surgically corrected one year before AMS800 implant in a patient and simultaneously in another patient. The cuff was placed around the bulbous urethra (9), pendulous urethra (1) or bladder neck (1). The device was activated 6 weeks post implantation, and the assessment of therapeutic effects was started 2 weeks after activation. RESULTS Follow up ranged from 3 weeks to 75 months, with a mean of 56 months, if 3 cases done explantation due to periprosthetic infections were excluded. After AMS 800 implantation 5 patients (45%) were completely continent, 4(36%) required the use of not more than 1 pad per day, while a patient was not satisfied with the results and another patient was not definitive because of early explantation before device activation. Hence complete or near complete continence was achieved in 9 patients (81%). A patient is performing intermittent self catheterization in conjunction with the AMS 800 without any complications up until now. There were 3 periprosthetic infections (27%) associated with 2 cuff erosions, that consequently required explantation. Besides periprosthetic infection, neither complications nor mechanical device failures was experienced. CONCLUSION In conclusion, the AMS 800 artificial urinary sphincter was safe with reasonable mechanical reliability and offered acceptable and satisfactory urinary control to the selected patients with incontinence. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|