Header

UZH-Logo

Maintenance Infos

Urethral pressure profile assessment after artificial urinary sphincter implantation (FlowSecure and AMS-800): A case series


Haab, Alexander C; Tornic, Jure; John, Hubert A (2019). Urethral pressure profile assessment after artificial urinary sphincter implantation (FlowSecure and AMS-800): A case series. Sage Open Medical Case Reports, 7:2050313X19851379.

Abstract

The AMS-800 artificial urinary sphincter has become the 'gold standard' in the treatment of male stress urinary incontinence. In 2006, the novel artificial urinary sphincter FlowSecure containing a stress relief balloon providing low cuff pressures at rest with conditional pressure elevation during periods of stress has been launched. We assessed the intraurethral pressure in the cuff area of the AMS-800 and the FlowSecure by urethral pressure profile in four patients each. Urethral pressure profile was performed at rest and during coughing. In addition, continence situation and patient satisfaction after artificial urinary sphincter implantation was assessed. At rest, median pressure in the cuff region was 74 (38-117, FlowSecure) cm HO and 102 (95-110, AMS-800) cm HO. During coughing, pressure peaks rose to 135 (54-162, FlowSecure) cm HO and 202 (128-216, AMS-800) cm HO. Median pad usage before artificial urinary sphincter implantation in the FlowSecure and the AMS-800 group was 4 (3-4) and 4.5 (2-6) pads/24 h, respectively. At the time of urodynamic investigation, median pad usage declined to 1.5 (0-4) pads/24 h in the FlowSecure and to 1 (1-2) pads/24 h in the AMS-800 group. Seven of eight patients reported on a satisfactory quality of life, and one patient remained unhappy after FlowSecure implantation. It remains unclear if the trade-off in favour of lower cuff pressures, and consecutively lower intraurethral pressures, holds truly long-term benefits regarding device revision, explantation and patient satisfaction.

Abstract

The AMS-800 artificial urinary sphincter has become the 'gold standard' in the treatment of male stress urinary incontinence. In 2006, the novel artificial urinary sphincter FlowSecure containing a stress relief balloon providing low cuff pressures at rest with conditional pressure elevation during periods of stress has been launched. We assessed the intraurethral pressure in the cuff area of the AMS-800 and the FlowSecure by urethral pressure profile in four patients each. Urethral pressure profile was performed at rest and during coughing. In addition, continence situation and patient satisfaction after artificial urinary sphincter implantation was assessed. At rest, median pressure in the cuff region was 74 (38-117, FlowSecure) cm HO and 102 (95-110, AMS-800) cm HO. During coughing, pressure peaks rose to 135 (54-162, FlowSecure) cm HO and 202 (128-216, AMS-800) cm HO. Median pad usage before artificial urinary sphincter implantation in the FlowSecure and the AMS-800 group was 4 (3-4) and 4.5 (2-6) pads/24 h, respectively. At the time of urodynamic investigation, median pad usage declined to 1.5 (0-4) pads/24 h in the FlowSecure and to 1 (1-2) pads/24 h in the AMS-800 group. Seven of eight patients reported on a satisfactory quality of life, and one patient remained unhappy after FlowSecure implantation. It remains unclear if the trade-off in favour of lower cuff pressures, and consecutively lower intraurethral pressures, holds truly long-term benefits regarding device revision, explantation and patient satisfaction.

Statistics

Citations

Altmetrics

Downloads

8 downloads since deposited on 11 Sep 2019
8 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:23 May 2019
Deposited On:11 Sep 2019 13:38
Last Modified:01 Oct 2019 12:31
Publisher:Sage Publications
ISSN:2050-313X
OA Status:Green
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1177/2050313X19851379
PubMed ID:31205716

Download

Green Open Access

Download PDF  'Urethral pressure profile assessment after artificial urinary sphincter implantation (FlowSecure and AMS-800): A case series'.
Preview
Content: Published Version
Filetype: PDF
Size: 615kB
View at publisher
Licence: Creative Commons: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)