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Current Bladder Dysfunction Reports

, Volume 12, Issue 4, pp 311–320 | Cite as

Use of Artificial Urinary Sphincter and Slings to Manage Neurogenic Bladder Following Spinal Cord Injury—Is It Safe?

  • Kathryn A. ScottEmail author
  • Michael Tonzi
  • Dmitriy Nikolavsky
Neurogenic Bladder (C Powell, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Neurogenic Bladder

Abstract

Purpose of Review

As an examination of available literature, this review summarizes the use of artificial urinary sphincters and urethral slings in patients with spinal cord injury and neurogenic bladder.

Recent Findings

A majority of studies are small and retrospective in nature. Study populations are frequently non-randomized with mixed etiology, including those with and without spinal cord injury. Sphincter use has been infrequently studied in females and remains the gold standard in males. New directions in research describe the use of robotic implantation to decrease complications.

Summary

Artificial urinary sphincter use in patients with spinal cord injury appears to be relatively safe. They achieve continence in most patients (89%, range 23–100%), though on review have high removal and revision rates. These are typically due to infection, erosions, and mechanical failure. Synthetic and autologous slings are described with continence rates of 33–90.9% and reoperations due to erosions occurring with a 3–11% rate.

Keywords

Neurogenic bladder Spinal cord injury Stress urinary incontinence Artificial urinary sphincter Retropubic sling Intrinsic sphincter deficiency 

Notes

Compliance with Ethical Standards

Conflict of Interest

Drs Scott, Tonzi and Nikolavsky do not have any conflict of interest.

Human and Animal Rights and Informed Consent

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

References

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

  1. 1.
    NSCISC. Facts and figures at a glance. University of Alabama at Birmingham; 2016.Google Scholar
  2. 2.
    Tapia CI, Khalaf K, Berenson K, Globe D, Chancellor M, Carr LK. Health-related quality of life and economic impact of urinary incontinence due to detrusor overactivity associated with a neurologic condition: a systematic review. Health Qual Life Outcomes. 2013;11:13.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Nevedal A, Kratz AL, Tate DG. Women's experiences of living with neurogenic bladder and bowel after spinal cord injury: life controlled by bladder and bowel. Disabil Rehabil. 2016;38(6):573–81.CrossRefPubMedGoogle Scholar
  4. 4.
    Stohrer M, Blok B, Castro-Diaz D, Chartier-Kastler E, Del Popolo G, Kramer G, et al. EAU guidelines on neurogenic lower urinary tract dysfunction. Eur Urol. 2009;56(1):81–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, et al. Fourth international consultation on incontinence recommendations of the international scientific committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213–40.CrossRefPubMedGoogle Scholar
  6. 6.
    Kathleen C. Kobashi; Michael E. Albo; Roger R. Dmochowski; David A. Ginsberg; Howard B. Goldman; Alexander Gomelsky; Stephen R. Kraus; Jaspreet S. Sandhu; Tracy Shepler; Jonathan R. Treadwell; Sandip Vasavada; Gary E. Lemack. Surgical treatment of female stress urinary incontinence (SUI): AUA/SUFU Guideline. 2017.Google Scholar
  7. 7.
    Scott FB, Bradley WE, Timm GW. Treatment of urinary incontinence by implantable prosthetic sphincter. Urology. 1973;1(3):252–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Light JK, Scott FB. Use of the artificial urinary sphincter in spinal cord injury patients. J Urol. 1983;130(6):1127–9.CrossRefPubMedGoogle Scholar
  9. 9.
    • Scott FB, Bradley WE, Timm GW, Kothari D. Treatment of incontinence secondary to myelodysplasia by an implantable prosthetic urinary sphincter. South Med J. 1973;66(9):987–90. First describes use of AUS. CrossRefPubMedGoogle Scholar
  10. 10.
    Gonzalez R, Dewolf WC. The artificial bladder sphincter AS-721 for the treatment of incontinence in patients with neurogenic bladder. J Urol. 1979;121(1):71–2.CrossRefPubMedGoogle Scholar
  11. 11.
    Gonzalez R, Sheldon CA. Artificial sphincters in children with neurogenic bladders: long-term results. J Urol. 1982;128(6):1270–2.CrossRefPubMedGoogle Scholar
  12. 12.
    Hanna MK. Artificial urinary sphincter for incontinent children. Urology. 1981;18(4):370–3.CrossRefPubMedGoogle Scholar
  13. 13.
    Myers JB, Mayer EN, Lenherr S. Management options for sphincteric deficiency in adults with neurogenic bladder. Transl Androl Urol. 2016;5(1):145–57.PubMedPubMedCentralGoogle Scholar
  14. 14.
    •• Chartier Kastler E, Genevois S, Game X, Denys P, Richard F, Leriche A, et al. Treatment of neurogenic male urinary incontinence related to intrinsic sphincter insufficiency with an artificial urinary sphincter: a French retrospective multicentre study. BJU Int. 2011;107(3):426–32. Largest study describing AUS placement at the bladder neck in a population of patients with neurogenic bladder. CrossRefPubMedGoogle Scholar
  15. 15.
    Singh G, Thomas DG. Artificial urinary sphincter in patients with neurogenic bladder dysfunction. Br J Urol. 1996;77(2):252–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Murphy S, Rea D, O'Mahony J, McDermott TE, Thornhill J, Butler M, et al. A comparison of the functional durability of the AMS 800 artificial urinary sphincter between cases with and without an underlying neurogenic aetiology. Ir J Med Sci. 2003;172(3):136–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Patki P, Hamid R, Shah PJ, Craggs M. Long-term efficacy of AMS 800 artificial urinary sphincter in male patients with urodynamic stress incontinence due to spinal cord lesion. Spinal Cord. 2006;44(5):297–300.CrossRefPubMedGoogle Scholar
  18. 18.
    Lai HH, Hsu EI, Teh BS, Butler EB, Boone TB. 13 years of experience with artificial urinary sphincter implantation at Baylor College of Medicine. J Urol. 2007;177(3):1021–5.CrossRefPubMedGoogle Scholar
  19. 19.
    James MH, McCammon KA. Artificial urinary sphincter for post-prostatectomy incontinence: a review. Int J Urol. 2014;21(6):536–43.CrossRefPubMedGoogle Scholar
  20. 20.
    •• Yates DR, Phe V, Roupret M, Vaessen C, Parra J, Mozer P, et al. Robot-assisted laparoscopic artificial urinary sphincter insertion in men with neurogenic stress urinary incontinence. BJU Int. 2013;111(7):1175–9. First report of robotic AUS placment. CrossRefPubMedGoogle Scholar
  21. 21.
    •• Farag F, Koens M, Sievert KD, De Ridder D, Feitz W, Heesakkers J. Surgical treatment of neurogenic stress urinary incontinence: a systematic review of quality assessment and surgical outcomes. Neurourol Urodyn. 2016;35(1):21–5. Review of surgical outcomes looking specifically at the under studied neurogenic stress UI population. CrossRefPubMedGoogle Scholar
  22. 22.
    Gonzalez R, Merino FG, Vaughn M. Long-term results of the artificial urinary sphincter in male patients with neurogenic bladder. J Urol. 1995;154(2 Pt 2):769–70.CrossRefPubMedGoogle Scholar
  23. 23.
    Costa P, Poinas G, Ben Naoum K, Bouzoubaa K, Wagner L, Soustelle L, et al. Long-term results of artificial urinary sphincter for women with type III stress urinary incontinence. Eur Urol. 2013;63(4):753–8.CrossRefPubMedGoogle Scholar
  24. 24.
    • Fournier G, Callerot P, Thoulouzan M, Valeri A, Perrouin-Verbe MA. Robotic-assisted laparoscopic implantation of artificial urinary sphincter in women with intrinsic sphincter deficiency incontinence: initial results. Urology. 2014;84(5):1094–8. Robotic placement of AUS is new and future direction of AUS surgery. Early report of robotic placement in females. CrossRefPubMedGoogle Scholar
  25. 25.
    Biardeau X, Rizk J, Marcelli F, Flamand V. Robot-assisted laparoscopic approach for artificial urinary sphincter implantation in 11 women with urinary stress incontinence: surgical technique and initial experience. Eur Urol. 2015;67(5):937–42.CrossRefPubMedGoogle Scholar
  26. 26.
    Peyronnet B, Vincendeau S, Tondut L, Bensalah K, Damphousse M, Manunta A. Artificial urinary sphincter implantation in women with stress urinary incontinence: preliminary comparison of robot-assisted and open approaches. Int Urogynecol J. 2016;27(3):475–81.CrossRefPubMedGoogle Scholar
  27. 27.
    Athanasopoulos A, Gyftopoulos K, McGuire EJ. Treating stress urinary incontinence in female patients with neuropathic bladder: the value of the autologous fascia rectus sling. Int Urol Nephrol. 2012;44(5):1363–7.CrossRefPubMedGoogle Scholar
  28. 28.
    Kakizaki H, Shibata T, Shinno Y, Kobayashi S, Matsumura K, Koyanagi T. Fascial sling for the management of urinary incontinence due to sphincter incompetence. J Urol. 1995;153(3 Pt 1):644–7.CrossRefPubMedGoogle Scholar
  29. 29.
    Daneshmand S, Ginsberg DA, Bennet JK, Foote J, Killorin W, Rozas KP, et al. Puboprostatic sling repair for treatment of urethral incompetence in adult neurogenic incontinence. J Urol. 2003;169(1):199–202.CrossRefPubMedGoogle Scholar
  30. 30.
    Abdul-Rahman A, Attar KH, Hamid R, Shah PJ. Long-term outcome of tension-free vaginal tape for treating stress incontinence in women with neuropathic bladders. BJU Int. 2010;106(6):827–30.CrossRefPubMedGoogle Scholar
  31. 31.
    Pannek J, Bartel P, Gocking K. Clinical usefulness of the transobturator sub-urethral tape in the treatment of stress urinary incontinence in female patients with spinal cord lesion. J Spinal Cord Med. 2012;35(2):102–6.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Losco GS, Burki JR, Omar YA, Shah PJ, Hamid R. Long-term outcome of transobturator tape (TOT) for treatment of stress urinary incontinence in females with neuropathic bladders. Spinal Cord. 2015;53(7):544–6.CrossRefPubMedGoogle Scholar
  33. 33.
    Pannek J, Wollner J. Treatment of stress urinary incontinence in men with spinal cord injury: minimally invasive=minimally effective? Spinal Cord. 2017.Google Scholar
  34. 34.
    Groen LA, Spinoit AF, Hoebeke P, Van Laecke E, De Troyer B, Everaert K. The AdVance male sling as a minimally invasive treatment for intrinsic sphincter deficiency in patients with neurogenic bladder sphincter dysfunction: a pilot study. Neurourol Urodyn. 2012;31(8):1284–7.CrossRefPubMedGoogle Scholar
  35. 35.
    Vainrib M, Reyblat P, Ginsberg D. Outcomes of male sling mesh kit placement in patients with neuropathic stress urinary incontinence: a single institution experience. Urol Int. 2015;95(4):406–10.CrossRefPubMedGoogle Scholar
  36. 36.
    Catti M, Lortat-Jacob S, Morineau M, Lottmann H. Artificial urinary sphincter in children—voiding or emptying? An evaluation of functional results in 44 patients. J Urol. 2008;180(2):690–3. discussion 3CrossRefPubMedGoogle Scholar
  37. 37.
    Bauer SB, Reda EF, Colodny AH, Retik AB. Detrusor instability: a delayed complication in association with the artificial sphincter. J Urol. 1986;135(6):1212–5.CrossRefPubMedGoogle Scholar
  38. 38.
    Lopez Pereira P, Somoza Ariba I, Martinez Urrutia MJ, Lobato Romero R, Jaureguizar ME. Artificial urinary sphincter: 11-year experience in adolescents with congenital neuropathic bladder. Eur Urol. 2006;50(5):1096–101. discussion 101CrossRefPubMedGoogle Scholar
  39. 39.
    Mundy AR, Stephenson TP. Selection of patients for implantation of the Brantley Scott artificial urinary sphincter. Br J Urol. 1984;56(6):717–20.CrossRefPubMedGoogle Scholar
  40. 40.
    Roth DR, Vyas PR, Kroovand RL, Perlmutter AD. Urinary tract deterioration associated with the artificial urinary sphincter. J Urol. 1986;135(3):528–30.CrossRefPubMedGoogle Scholar
  41. 41.
    Murray KH, Nurse DE, Mundy AR. Detrusor behaviour following implantation of the Brantley Scott artificial urinary sphincter for neuropathic incontinence. Br J Urol. 1988;61(2):122–8.CrossRefPubMedGoogle Scholar
  42. 42.
    Bersch U, Gocking K, Pannek J. The artificial urinary sphincter in patients with spinal cord lesion: description of a modified technique and clinical results. Eur Urol. 2009;55(3):687–93.CrossRefPubMedGoogle Scholar
  43. 43.
    Foley SJ, McFarlane JP, Shah PJ. Artificial urinary sphincters and the detrusor pressure in the neuropathic bladder. Br J Urol. 1996;78(5):808–9.PubMedGoogle Scholar
  44. 44.
    Levesque PE, Bauer SB, Atala A, Zurakowski D, Colodny A, Peters C, et al. Ten-year experience with the artificial urinary sphincter in children. J Urol. 1996;156(2 Pt 2):625–8.CrossRefPubMedGoogle Scholar
  45. 45.
    Kryger JV, Leverson G, Gonzalez R. Long-term results of artificial urinary sphincters in children are independent of age at implantation. J Urol. 2001;165(6 Pt 2):2377–9.CrossRefPubMedGoogle Scholar
  46. 46.
    Kronner KM, Rink RC, Simmons G, Kropp BP, Casale AJ, Cain MP. Artificial urinary sphincter in the treatment of urinary incontinence: preoperative urodynamics do not predict the need for future bladder augmentation. J Urol. 1998;160(3 Pt 2):1093–5. discussion 103PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Kathryn A. Scott
    • 1
    Email author
  • Michael Tonzi
    • 1
  • Dmitriy Nikolavsky
    • 1
  1. 1.Department of UrologySUNY Upstate Medical CenterSyracuseUSA

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