Transcorporal vs. bulbar artificial urinary sphincter implantation in male patients with fragile urethra View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-07-17

AUTHORS

Mehdi El-Akri, Imad Bentellis, Thibault Tricard, Thibaut Brierre, Tiffany Cousin, Hugo Dupuis, Nicolas Hermieu, Victor Gaillard, Baptiste Poussot, Damien Robin, Alice Pitout, Florian Beraud, Priscilla Bertrand-Leon, Daniel Chevallier, Franck Bruyere, Xavier Biardeau, Hervé Monsaint, Luc Corbel, Christian Saussine, Jean-Francois Hermieu, Pierre Lecoanet, Grégoire Capon, Jean-Nicolas Cornu, Xavier Game, Alain Ruffion, Benoit Peyronnet

ABSTRACT

PurposeTo compare transcorporal vs bulbar artificial urinary sphincter (AUS) implantation in men with fragile urethra and to investigate the risk factors of AUS explantation in this population. MethodsThe charts of all male patients who had an AUS implantation between 2004 and 2020 in 16 centers were reviewed retrospectively. The primary endpoint was device explantation-free survival. Only patients with a fragile urethra were included in the present analysis. Fragile urethra was defined as a urethra carrying a high risk of cuff erosion because of prior radiotherapy and/or history of AUS explantation and/or history of urethral stricture surgery. The patients were divided in two groups according to the implantation site: bulbar vs transcorporal. Results 464 patients were included for analysis. 88 patients underwent a transcorporal AUS implantation and 376 underwent a bulbar AUS implantation. Explantation-free survival was similar in both groups (estimated 5-year explantation free survival rates 55.3% vs. 58.4%; p=0.98). In the subgroup of patients with a history of previous AUS explantation, transcorporal approach tended to bring longer explantation-free survival (2-year explantation-free survival: 61.9% vs. 58.2%; p=0.096). In multivariate analysis, the only risk factor of shorter explantation-free survival was the history of previous AUS explantation (HR=2.65; p=0.01). ConclusionsTranscorporal AUS implantation was not associated with longer explantation-free survival. History of previous AUS explantation was the only risk factor associated with shorter explantation-free survival and this subgroup of patients may be the only one to draw benefits of transcorporal AUS implantation. More... »

PAGES

4449-4457

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-021-03783-6

DOI

http://dx.doi.org/10.1007/s00345-021-03783-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1139743004

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34272596


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19 schema:description PurposeTo compare transcorporal vs bulbar artificial urinary sphincter (AUS) implantation in men with fragile urethra and to investigate the risk factors of AUS explantation in this population. MethodsThe charts of all male patients who had an AUS implantation between 2004 and 2020 in 16 centers were reviewed retrospectively. The primary endpoint was device explantation-free survival. Only patients with a fragile urethra were included in the present analysis. Fragile urethra was defined as a urethra carrying a high risk of cuff erosion because of prior radiotherapy and/or history of AUS explantation and/or history of urethral stricture surgery. The patients were divided in two groups according to the implantation site: bulbar vs transcorporal. Results 464 patients were included for analysis. 88 patients underwent a transcorporal AUS implantation and 376 underwent a bulbar AUS implantation. Explantation-free survival was similar in both groups (estimated 5-year explantation free survival rates 55.3% vs. 58.4%; p=0.98). In the subgroup of patients with a history of previous AUS explantation, transcorporal approach tended to bring longer explantation-free survival (2-year explantation-free survival: 61.9% vs. 58.2%; p=0.096). In multivariate analysis, the only risk factor of shorter explantation-free survival was the history of previous AUS explantation (HR=2.65; p=0.01). ConclusionsTranscorporal AUS implantation was not associated with longer explantation-free survival. History of previous AUS explantation was the only risk factor associated with shorter explantation-free survival and this subgroup of patients may be the only one to draw benefits of transcorporal AUS implantation.
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