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      Patients’ quality of life after implantation of ZSI 375 artificial urinary sphincter due to stress urinary incontinence

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          Abstract

          Introduction

          The study aimed to evaluate the outcomes of artificial urinary sphincter ZSI 375 implantation for stress urinary incontinence, focusing on quality of life assessment (QoL).

          Material and methods

          The study had a prospective and non-randomized design. It was conducted in two urological centres in Poland. Between July 2013 and June 2019, artificial urinary sphincter ZSI 375 was implanted in 86 consecutive men with stress urinary incontinence. The follow up was completed in December 2019. The assessment of functional results was based on number of pads used and declared to have been used by patients. The quality of life was assessed on the basis of the ICIQ-SF questionnaire (International Consultation on Incontinence Questionnaire-Short Form), SF-36 questionnaire (Short Form 36 Health Survey Questionnaire) and the severity of pain by means of the NRS (numerical rating scale of pain intensity).

          Results

          The operations were performed in 86 patients aged 28 to 80 (median 69). With the median (SD; range) follow-up of 21 (20.2; 1–68) months, daily pad usage decreased significantly from ≥4 to 1.1 (±0.97 pads) per day. Seven (8.1%) patients achieved total continence, 60 (69.8%) social continence, 14 (16.3%) improvement and 5 (5.8%) failures (≥4 pads per day). 15 patients (17.5%) experienced complications after surgery. The study showed a significant improvement of QoL evaluated by ICIQ-UI SF and SF-36.

          Conclusions

          Therapy with the use of ZSI 375 device is successfully applied in surgical management of moderate to severe male stress urinary incontinence. The life quality of patients assessed using questionnaires is at a high level.

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          Most cited references32

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          Short form 36 (SF36) health survey questionnaire: normative data for adults of working age.

          C Jenkinson, A. Coulter, L. Wright (1993)
          To gain population norms for the short form 36 health survey questionnaire (SF36) in a large community sample and to explore the questionnaire's internal consistency and validity. Postal survey by using a booklet containing the SF36 and several other items concerned with lifestyles and illness. The sample was drawn from computerised registers of the family health services authorities for Berkshire, Buckinghamshire, Northamptonshire, and Oxfordshire. 13,042 randomly selected subjects aged 18-64 years. Scores for the eight health dimensions of the SF36. The survey achieved a response rate of 72% (n = 9332). Internal consistency of the different dimensions of the questionnaire was high. Normative data broken down by age, sex, and social class were consistent with those from previous studies. The SF36 is a potentially valuable tool in medical research. The normative data provided here may further facilitate its validation and use.
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            13 years of experience with artificial urinary sphincter implantation at Baylor College of Medicine.

            H Lai, Elias I Hsu, Bin S. Teh … (2007)
            We reviewed 13 years of experience with artificial urinary sphincter implantation (narrow backed cuff) at a single institution. Between 1992 and 2005, 270 patients underwent artificial urinary sphincter implantation, as performed by a single surgeon at Baylor College of Medicine, and followup data were available on 218 of them. Mean followup was 36.5 months (maximum 151.4). Of the 218 patients 60 underwent prostatectomy and pelvic radiation, 116 underwent prostatectomy without radiotherapy, 11 had neurogenic bladder and 31 underwent secondary artificial urinary sphincter implantation. The complication rate did not differ among the 4 treatment groups. Complication rates were infection in 5.5% of cases, erosion in 6.0%, urethral atrophy in 9.6%, mechanical failure in 6.0% and surgical removal or revision in 27.1%. Median time to complications was 3.7 months for infection, 19.8 months for erosion, 29.6 months for atrophy, 68.1 months for failure and 14.4 months for surgery. At 5 years 75% of patients were free from revision or removal. A history of failed injectable or male sling, or of Valsalva voiding did not adversely impact the outcome. The rate of bladder neck contracture was high in artificial urinary sphincter candidates, especially in irradiated patients (36% and 57%, respectively). Patients with prior pelvic radiation continued to be at higher risk for contracture recurrence after artificial urinary sphincter implantation (12%). Two-stage UroLume stent and artificial urinary sphincter placement offered long-term contracture and continence control in 8 of 11 patients with recurrent anastomotic contractures. An artificial urinary sphincter is durable treatment for sphincter deficiency even in patients with a history of complications, neurogenic bladder, pelvic radiation, bladder neck contracture, Valsalva voiding, or failed injectables or slings.
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              Contemporary management of postprostatectomy incontinence.

              R Bauer, W Hübner, V W Nitti … (2011)
              In recent years, despite improvement in the surgical technique, the prevalence of postprostatectomy incontinence has increased due to a rise in the number of radical prostatectomies performed annually. The aim of this review is to evaluate contemporary noninvasive and invasive treatment options for postprostatectomy incontinence. In August 2010, a review of the literature was performed using the Medline database. All articles concerning noninvasive and invasive treatment for postprostatectomy incontinence were included. No randomised controlled trials exist to compare currently used noninvasive and invasive treatments for postprostatectomy incontinence. Pelvic floor muscle training is recommended for the initial treatment of stress urinary incontinence (SUI). Additionally, antimuscarinic therapy should be applied for urgency or urge incontinence. For decades, the artificial urinary sphincter was the reference standard for persistent SUI. Nowadays, male slings are an alternative for men with mild to moderate postprostatectomy SUI. Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cent European J Urol
                Journal ID (iso-abbrev): Cent European J Urol
                Journal ID (publisher-id): CEJU
                Title: Central European Journal of Urology
                Publisher: Polish Urological Association
                ISSN (Print): 2080-4806
                ISSN (Electronic): 2080-4873
                Publication date (Electronic): 19 June 2020
                Publication date (Print): 2020
                Volume: 73
                Issue: 2
                Pages: 178-186
                Affiliations
                [1 ]Department of Urology and Urological Oncology, Regional Specialistic Hospital, Puławy, Poland
                [2 ]Department of Urology, Jagiellonian University Medical College, Cracow, Poland
                [3 ]Collegium Medicum of Nicolaus Copernicus University, Clinic of General and Oncological Urology, Bydgoszcz, Poland
                Author notes
                Corresponding author Ireneusz Ostrowski, Department of Urology and Urological Oncology, Regional Specialistic Hospital, 1 Bema Street, 24-100 Puławy, Poland. phone: +48 505 017 045. irekostrowski@ 123456op.pl
                Article
                Publisher ID: 0088
                DOI: 10.5173/ceju.2020.0088
                PMC ID: 7407780
                SO-VID: dc0c63dd-58ea-4c29-a5c3-cdc766217a1b
                Copyright © Copyright by Polish Urological Association
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

                History
                Date received : 20 May 2020
                Date revision received : 01 June 2020
                Date accepted : 02 June 2020
                Categories
                Subject: Original Paper

                Keywords: artificial urinary sphincter,male incontinence,quality of life,zsi 375
                Data availability:
                Keywords: artificial urinary sphincter, male incontinence, quality of life, zsi 375

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