Functional results of 3.5 cm cuffs compared to larger cuffs in men with an artificial urinary sphincter

Weis, Sylvia; Peyronnet, Beno&#238;t; Bentellis, Imad; Biardeau, Xavier; Capon, Gr&#233;goire; Lecoanet, Pierre; Tricard, Thibault; Bruy&#232;re, Franck; Saussine, Christian; Gam&#233;, Xavier; Cornu, Jean-Nicolas; Hermieu, Nicolas

Functional results of 3.5 cm cuffs compared to larger cuffs in men with an artificial urinary sphincter

Weis S¹, Peyronnet B², Bentellis I³, Biardeau X⁴, Capon G⁵, Lecoanet P⁶, Tricard T⁷, Bruyère F⁸, Saussine C⁷, Gamé X⁹, Cornu J¹⁰, Hermieu N¹

Research Type

Clinical

Abstract Category

Male Stress Urinary Incontinence (Post Prostatectomy Incontinence)

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Links
	Abstract 264
	Male Incontinence Scientific Podium Short Oral Session 31
	Friday 29th September 2023
	11:52 - 12:00
	Room 104AB
	Stress Urinary Incontinence Incontinence Male
	1. Department of Urology, Bichat Claude Bernard Hospital, Paris, France, 2. Department. of Urology, Rennes University Hospital, Rennes, France, 3. Department of Urology, University of Nice, Nice, France, 4. Department of Urology, University of Lille, Lille, France., 5. Department of Urology, University of Bordeaux, Bordeaux, France, 6. Department of Urology, University of Nancy, Nancy, France, 7. Department of Urology, University of Strasbourg, Strasbourg, France, 8. Department of Urology, University of Tours, Tours, France, 9. Department of Urology, University of Toulouse, Toulouse, France, 10. Department of Urology, Charles Nicolle University Hospital, Rouen, France
Presenter
B Benoît Peyronnet
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Abstract

Hypothesis / aims of study

To evaluate the functional outcomes of 3.5 cm artificial urinary sphincter (AUS) cuffs compared with 4 to 4.5 cm cuffs in men.

Study design, materials and methods

Retrospective analysis of a French multicenter database of AUS in men between 1991 and 2020. Exclusion criteria: cuff > 4.5 cm, follow-up < 6 months. Primary endpoint: AUS explantation rate; secondary endpoints: social continence rate at the end of the follow-up, postoperative complications according to Clavien-Dindo, urethral erosion rate. The cohort was divided into two groups: 3.5 cm cuffs (A) vs. 4 to 4.5 cm cuffs (B). Statistical analysis on the primary endpoint: descriptive statistics, analysis of survival without explantation according to Kaplan-Meier and Cox model.

Results

Out of 1253 patients analyzed, 710 were included, 73 in group A and 637 in group B. Median age: 70 years (65-75) ; median follow-up : 34 months (17-64). The AUS explantation rate was higher in group A than in group B (A : n = 26 (35.6 %) vs B: n = 150 (23.5 %), p < 0.05) with shorter survival without explantation in group A than in group B (hazard ratio HR = 1.8 [1.06-3.1]). In addition, the rate of social continence at the end of follow-up was lower in group A than in group B (A : n = 30 (41.1 %) vs B: n = 342 (53.7 %); OR = 0.43 [0.2-0.9], p < 0.05) and the rate of postoperative complications was higher in group A than in group B (A: n = 15 (20.5 %) vs B : n = 68 (10.7 %); OR = 2,2 [1,1-4,2], p < 0.05). On the other hand, the rate of urethral erosion was not significantly different between group A and group B (A: n = 12 (16.4 %) vs B: n = 73 (11.5 %); OR = 1,5 [0,7-3,0], p = 0.25).

Interpretation of results

The study evaluated the functional outcomes of 3.5 cm AUS cuffs compared with 4 to 4.5 cm cuffs in men. The results showed that the use of 3.5 cm AUS cuffs was associated with a higher rate of explantation and postoperative complications, as well as a lower rate of social continence, compared to the larger size cuffs. However, there was no significant difference in terms of urethral erosion between the two groups.

Concluding message

Our findings suggest that the use of larger size cuffs resulted in better functional outcomes and fewer postoperative complications and explantations than 3.5 cm cuffs in men who underwent AUS implantation

Figure 1

Patient characteristics and results

Figure 2

Explantation free survival according to the cuff size 3,5 cm

Disclosures

Funding NONE Clinical Trial No Subjects Human Ethics not Req'd As this was a retrospective study, this study did not contain any contact with human participants or animals performed by any of the authors. French law does not require ethics committee approval or informed consent for retrospective data collection Helsinki Yes Informed Consent Yes

Citation

Continence 7S1 (2023) 100981
DOI: 10.1016/j.cont.2023.100981