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Anti-incontinence Surgery in High-Risk Male Patients with Stress Urinary Incontinence—an Updated Review

  • Post-Prostatectomy and Acquired Voiding Dysfunction (V Tse, Section Editor)
  • Published:
Current Bladder Dysfunction Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The objective of this manuscript is to review the current literature on anti-incontinence treatment for high-risk patients with stress urinary incontinence (SUI).

Recent Findings

The occurrence of SUI has been documented as a sequelae following radical prostatectomy (RP), radiation therapy, or transurethral resection of the prostate (TURP). Throughout its evolution, the artificial urinary sphincter (AUS) has become the current gold standard for male SUI. Another treatment for men with mild-to-moderate SUI is with the use of a male sling.

Summary

This review will highlight the treatment options of male slings and AUS in high-risk patients with SUI, report on the outcomes and complications of these treatments, as well as comment on personal insights with this cohort of patients touching on future options.

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References

Papers of particular interest, published recently, have been highlighted as:•• Of major importance

  1. Markland AD, Richter HE, Fwu CW, Eggers P, Kusek JW. Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008. J Urol. 2011;186(2):589–93.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Anger JT, Saigal CS, Stothers L, Thom DH, Rodriguez LV, Litwin MS. The prevalence of urinary incontinence among community dwelling men: results from the National Health and Nutrition Examination survey. J Urol. 2006;176(5):2103–8. discussion 2108

    Article  PubMed  Google Scholar 

  3. National Institute of Diabetes and Digestive and Kidney Diseases. Bladder control problems in men (urinary incontinence). https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-men. November 2015.

  4. Sandhu JS. Treatment options for male stress urinary incontinence. Nat Rev Urol. 2010;7(4):222–8.

    Article  PubMed  Google Scholar 

  5. Walsh PC, Marschke P, Ricker D, Burnett AL. Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology. 2000;55(1):58–61.

    Article  CAS  PubMed  Google Scholar 

  6. Thom D. Variation in estimates of urinary incontinence prevalence in the community: effects of differences in definition, population characteristics, and study type. J Am Geriatr Soc. 1998;46(4):473–80.

    Article  CAS  PubMed  Google Scholar 

  7. Treiyer A, Anheuser P, Butow Z, Steffens J. A single center prospective study: prediction of postoperative general quality of life, potency and continence after radical retropubic prostatectomy. J Urol. 2011;185(5):1681–5.

    Article  PubMed  Google Scholar 

  8. Rosen M. Department of Urology WHNSWA. A simple artificial implantable sphincter. BJU Int. 1976;48(7):675–80.

    Article  CAS  Google Scholar 

  9. Scott FB. The artificial sphincter in the management of incontinence in the male. Urol Clin North Am. 1978;5(2):375–91.

    CAS  PubMed  Google Scholar 

  10. •• Yafi FA, DeLay KJ, Stewart C, Chiang J, Sangkum P, Hellstrom WJ. Device survival after primary implantation of an artificial urinary sphincter for male stress urinary incontinence. J Urol. 2016;197(3 Pt 1):759–65. This landmark study demonstrated the AMS 800 was durable in males leading to lower complications and reintervention.

    PubMed  Google Scholar 

  11. Trost L, Elliott DS. Male stress urinary incontinence: a review of surgical treatment options and outcomes. Adv Urol. 2012;2012:287489.

    Article  PubMed  PubMed Central  Google Scholar 

  12. •• Ahyai SA, Ludwig TA, Dahlem R, et al. Outcomes of single- vs double-cuff artificial urinary sphincter insertion in low- and high-risk profile male patients with severe stress urinary incontinence. BJU Int. 2016;118(4):625–32. Patients had better continence outcomes in high risk patients who received a double cuff artificial urinary sphincter compared to low-risk patients who received a single cuff artificial urinary sphincter.

    Article  PubMed  Google Scholar 

  13. Brant WO, Erickson BA, Elliott SP, et al. Risk factors for erosion of artificial urinary sphincters: a multicenter prospective study. Urology. 2014;84(4):934–8.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Burkhard FC, Bosch JLHR, Cruz F, et al. Urinary incontinence. http://uroweb.org/guideline/urinary-incontinence. 2015

  15. Anusionwu II, Wright EJ. Indications for revision of artificial urinary sphincter and modifiable risk factors for device-related morbidity. Neurourol Urodyn. 2013;32(1):63–5.

    Article  PubMed  Google Scholar 

  16. Trost L, Elliott D. Small intestinal submucosa urethral wrap at the time of artificial urinary sphincter placement as a salvage treatment option for patients with persistent/recurrent incontinence following multiple prior sphincter failures and erosions. Urology. 2011;79(4):933–8.

    Article  PubMed  Google Scholar 

  17. Lee D, Zafirakis H, Shapiro A, Westney OL. Intermediate outcomes after transcorporal placement of an artificial urinary sphincter. Int J Urol. 2012;19(9):861–6.

    Article  PubMed  Google Scholar 

  18. Wiedemann L, Cornu JN, Haab E, et al. Transcorporal artificial urinary sphincter implantation as a salvage surgical procedure for challenging cases of male stress urinary incontinence: surgical technique and functional outcomes in a contemporary series. BJU Int. 2013;112(8):1163–8.

    Article  PubMed  Google Scholar 

  19. Linder BJ, de Cogain M, Elliott DS. Long-term device outcomes of artificial urinary sphincter reimplantation following prior explantation for erosion or infection. J Urol. 2013;191(3):734–8.

    Article  PubMed  Google Scholar 

  20. Kretschmer A, Buchner A, Grabbert M, Stief CG, Pavlicek M, Bauer RM. Risk factors for artificial urinary sphincter failure. World J Urol. 2015;34(4):595–602.

    Article  PubMed  Google Scholar 

  21. Wang R, McGuire EJ, He C, Faerber GJ, Latini JM. Long-term outcomes after primary failures of artificial urinary sphincter implantation. Urology. 2012;79(4):922–8.

    Article  PubMed  Google Scholar 

  22. •• Leon P, Chartier-Kastler E, Roupret M, Ambrogi V, Mozer P, Phe V. Long-term functional outcomes after artificial urinary sphincter implantation in men with stress urinary incontinence. BJU Int. 2014;115(6):951–7. Patients with a history of prior radiation, age >69, BMI >25 kg/m2, and history of AUS revisions were not risk factors for AUS revision or explantation.

    Article  PubMed  Google Scholar 

  23. Lai HH, Boone TB. Complex artificial urinary sphincter revision and reimplantation cases—how do they fare compared to virgin cases? J Urol. 2012;187(3):951–5.

    Article  PubMed  Google Scholar 

  24. Hubner WA, Gallistl H, Rutkowski M, Huber ER. Adjustable bulbourethral male sling: experience after 101 cases of moderate-to-severe male stress urinary incontinence. BJU Int. 2010;107(5):777–82.

    Article  PubMed  Google Scholar 

  25. Lentz AC, Peterson AC, Webster GD. Outcomes following artificial sphincter implantation after prior unsuccessful male sling. J Urol. 2012;187(6):2149–53.

    Article  PubMed  Google Scholar 

  26. Kim JC, Cho KJ. Current trends in the management of post-prostatectomy incontinence. Kor J Urol. 2012;53(8):511–8.

    Article  Google Scholar 

  27. Welk BK, Herschorn S. The male sling for post-prostatectomy urinary incontinence: a review of contemporary sling designs and outcomes. BJU Int. 2011;109(3):328–44.

    Article  PubMed  Google Scholar 

  28. •• Carmel M, Hage B, Hanna S, Schmutz G, Tu le M. Long-term efficacy of the bone-anchored male sling for moderate and severe stress urinary incontinence. BJU Int. 2010;106(7):1012–6. Bone-anchored male sling placement in 45 males with moderate-to-severe incontinence was found to be successful in 76% of patients.

    Article  PubMed  Google Scholar 

  29. Torrey R, Rajeshuni N, Ruel N, Muldrew S, Chan K. Radiation history affects continence outcomes after advance transobturator sling placement in patients with post-prostatectomy incontinence. Urology. 2013;82(3):713–7.

    Article  PubMed  Google Scholar 

  30. Cornu JN, Sebe P, Ciofu C, Peyrat L, Cussenot O, Haab F. Mid-term evaluation of the transobturator male sling for post-prostatectomy incontinence: focus on prognostic factors. BJU Int. 2010;108(2):236–40.

    Article  PubMed  Google Scholar 

  31. Bauer RM, Soljanik I, Fullhase C, et al. Mid-term results for the retroluminar transobturator sling suspension for stress urinary incontinence after prostatectomy. BJU Int. 2010;108(1):94–8.

    Article  PubMed  Google Scholar 

  32. Bauer RM, Soljanik I, Fullhase C, et al. Results of the AdVance transobturator male sling after radical prostatectomy and adjuvant radiotherapy. Urology. 2010;77(2):474–9.

    Article  PubMed  Google Scholar 

  33. Soljanik I, Gozzi C, Becker AJ, Stief CG, Bauer RM. Risk factors of treatment failure after retrourethral transobturator male sling. World J Urol. 2011;30(2):201–6.

    Article  PubMed  Google Scholar 

  34. Seweryn J, Bauer W, Ponholzer A, Schramek P. Initial experience and results with a new adjustable transobturator male system for the treatment of stress urinary incontinence. J Urol. 2012;187(3):956–61.

    Article  PubMed  Google Scholar 

  35. Bochove-Overgaauw DM, Schrier BP. An adjustable sling for the treatment of all degrees of male stress urinary incontinence: retrospective evaluation of efficacy and complications after a minimal followup of 14 months. J Urol. 2011;185(4):1363–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Weill Cornell Medicine, 425 East 61st Street, 12th Floor, New York, NY, 10065, USA

    Dominique Thomas, Nadir Zaidi & Bilal Chughtai

Authors
  1. Dominique Thomas
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  2. Nadir Zaidi
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  3. Bilal Chughtai
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Corresponding author

Correspondence to Bilal Chughtai.

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Conflict of Interest

Thomas, Zaidi, and Chughtai have no conflict of interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the authors.

Additional information

Dominique Thomas and Nadir Zaidi are the co-first authors.

This article is part of the Topical Collection on Post-Prostatectomy and Acquired Voiding Dysfunction

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Thomas, D., Zaidi, N. & Chughtai, B. Anti-incontinence Surgery in High-Risk Male Patients with Stress Urinary Incontinence—an Updated Review. Curr Bladder Dysfunct Rep 12, 189–194 (2017). https://doi.org/10.1007/s11884-017-0444-1

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  • DOI: https://doi.org/10.1007/s11884-017-0444-1

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