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

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 H2O and 102 (95-110, AMS-800) cm H2O. During coughing, pressure peaks rose to 135 (54-162, FlowSecure) cm H2O and 202 (128-216, AMS-800) cm H2O. 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.

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  • Authors+Show Affiliations

    ,

    Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland.

    ,

    Department of Neuro-Urology, Spinal Cord Injury Centre & Research, University Hospital Balgrist, Zürich, Switzerland.

    Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland.

    Source

    SAGE open medical case reports 7: 2019 pg 2050313X19851379

    Pub Type(s)

    Case Reports

    Language

    eng

    PubMed ID

    31205716

    Citation

    Haab, Alexander C., et al. "Urethral Pressure Profile Assessment After Artificial Urinary Sphincter Implantation (FlowSecure™ and AMS-800™): a Case Series." SAGE Open Medical Case Reports, vol. 7, 2019, p. 2050313X19851379.
    Haab AC, Tornic J, John HA. Urethral pressure profile assessment after artificial urinary sphincter implantation (FlowSecure™ and AMS-800™): A case series. SAGE Open Med Case Rep. 2019;7:2050313X19851379.
    Haab, A. C., Tornic, J., & John, H. A. (2019). Urethral pressure profile assessment after artificial urinary sphincter implantation (FlowSecure™ and AMS-800™): A case series. SAGE Open Medical Case Reports, 7, p. 2050313X19851379. doi:10.1177/2050313X19851379.
    Haab AC, Tornic J, John HA. Urethral Pressure Profile Assessment After Artificial Urinary Sphincter Implantation (FlowSecure™ and AMS-800™): a Case Series. SAGE Open Med Case Rep. 2019;7:2050313X19851379. PubMed PMID: 31205716.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Urethral pressure profile assessment after artificial urinary sphincter implantation (FlowSecure™ and AMS-800™): A case series. AU - Haab,Alexander C, AU - Tornic,Jure, AU - John,Hubert A, Y1 - 2019/05/23/ PY - 2019/03/05/received PY - 2019/04/26/accepted PY - 2019/6/18/entrez PY - 2019/6/18/pubmed PY - 2019/6/18/medline KW - FlowSecure™ KW - artificial urinary sphincter KW - male stress urinary incontinence KW - urethral pressure profile KW - urodynamic investigation SP - 2050313X19851379 EP - 2050313X19851379 JF - SAGE open medical case reports JO - SAGE Open Med Case Rep VL - 7 N2 - 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 H2O and 102 (95-110, AMS-800) cm H2O. During coughing, pressure peaks rose to 135 (54-162, FlowSecure) cm H2O and 202 (128-216, AMS-800) cm H2O. 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. SN - 2050-313X UR - https://www.unboundmedicine.com/medline/citation/31205716/Urethral_pressure_profile_assessment_after_artificial_urinary_sphincter_implantation_(FlowSecure™_and_AMS-800™):_A_case_series L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31205716/ DB - PRIME DP - Unbound Medicine ER -