Management of male and female neurogenic stress urinary incontinence in spinal cord injured (SCI) patients using adjustable continence therapy
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Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsEnrico Ammirati, Alberto Manassero, Alessandro Giammò, Roberto Carone
Artificial urinary sphincter (AUS) is an option for the treatment of neurogenic stress urinary incontinence (nSUI), but complications and re-operation rates are high, and there is no clear indication from guidelines (
We retrospectively includedpatients with spinal cord injuries in this study, complaining of nSUI and treated at our Institution with Pro-ACT/ACT® implantation. Diagnosis of nSUI was achieved with clinical history data collection and video-urodynamic testing.
We treated 13 males and 3 females by proACT/ACT device, mean age 47.5 years (range 27-71). Fifteen implantations were performed bilaterally under spinal anesthesia and under fluoroscopic control; in one male patient, only the right balloon was implanted. Mean refilling number was 2.8 (range 0-6), and mean final volume was 3.6 ml. No patient reported any perioperative complications according to Clavien-Dindo. Follow-up was 37 months (range 7-156). Five patients (31%) underwent device explantation for deflate in one case, erosion or migration in three cases (18%), and infection in one case. About 43.75% of patients were dry and 18.75% improved more than 50% their urine loss, 37.5% of patients improved less than 50%, and no one reported worsening of incontinence.
Implantation of proACT/ACT® device is safe and a minimally invasive procedure also in neurological patients, with a relative low rate of intra and postoperative complications. Efficacy is good, although slightly lower than the results in non-neurological patients.
- • Accepted on 05/04/2017
- • Available online on 16/05/2017
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- Ammirati, Enrico [PubMed] [Google Scholar] 1, * Corresponding Author (email@example.com)
- Manassero, Alberto [PubMed] [Google Scholar] 2
- Giammò, Alessandro [PubMed] [Google Scholar] 2
- Carone, Roberto [PubMed] [Google Scholar] 2
Department of Urology, Città della Salute e della Scienza di Torino, Molinette Hospital, Turin - Italy
Department of Neuro-Urology, Città della Salute e della Scienza di Torino, CTO-USU, Turin - Italy