Urodynamic parameters evolution after artificial urinary sphincter implantation for post-radical prostatectomy incontinence with concomitant bladder dysfunction.

摘要

INTRODUCTION: Urodynamic assessment is strongly recommended before artificial urinary sphincter (AUS) implantation. Detrusor overactivity (DO) and/or hypersensitivity and/or mild loss of compliance are frequently demonstrated in post prostatectomy incontinence. The aim of this study was to evaluate urodynamic parameter changes before and after AUS implantation in patients with urinary incontinence post-radical prostatectomy (RP) and concomitant urodynamic bladder abnormalities. MATERIALS AND METHODS: We performed a retrospective review of charts pre- and post-AUS implantation. Sixteen out of a cohort of 52 patients met our inclusion criteria: stress urinary incontinence (SUI) due to RP and bladder dysfunction (early bladder sensation and/or low compliance and/or small bladder capacity and/or the presence of DO). RESULTS: The mean age of these 16 patients was 68 +/- 6.3 years, and the duration of incontinence was 3 +/- 2.7 years. The number of pads/day was 5.7 +/- 2.3 before AUS implantation, and 1 +/- 0.7 after implantation. Average time for the last post-implantation UDS was 43 months (range 7 to 73 months). Comparison of pre- and post-AUS implantation urodynamic parameters revealed statistically significant improvement in bladder capacity from 271 +/- 117 to 295.6 +/- 151 mL (p = 0.05), bladder compliance from 7.6 +/- 3.95 to 12.5 +/- 10.3 mL/cmH2O (p = 0.03), and decrease in DO from 50% to 25% on cystometrograms. CONCLUSION: Preoperative urodynamic abnormalities improved after AUS implantation. Thus, mild bladder dysfunction should not be a contraindication to AUS placement for SUI post-RP.