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PD32-12 REFILLABLE ARTIFICIAL URINARY SPHINCTER
ZSI 375 PF: SPANISH MULTICENTRE
EXPERIENCE.[Miscellaneous]
Accession Number:
00076734-201904001-01247.
Author:
Padilla-Fernandez*, Barbara; Gonzalez-Lopez, Raquel; Resel-
Folkersma, Luis; Madurga-Patuel, Blanca; Garde-Garcia, Hector;
Hernandez-Hernandez, David; Fernanda Lorenzo-Gomez, Maria;
Concepcion-Masip, Tomas; Moreno-Sierra, Jesus; Gonzalez-Enguita,
Carmen; Castro-Diaz, David Manuel
Institution:
San Cristobal de La Laguna, Spain;
Madrid, Spain;
Cadiz, Spain;
Madrid, Spain;
San Cristobal de La Laguna, Spain;
Salamanca, Spain;
San Cristobal de La Laguna, Spain;
Madrid, Spain;
San Cristobal de La Laguna, Spain
Title:
PD32-12 REFILLABLE ARTIFICIAL URINARY SPHINCTER ZSI 375 PF:
SPANISH MULTICENTRE EXPERIENCE.[Miscellaneous]
Source:
Journal of Urology. 201 (Supplement 1):e576, April 2019.
Abstract:
INTRODUCTION AND OBJECTIVES: Objective: to report the
experience in 4 tertiary hospitals with the pre-connected, pre-filled
and refillable artificial urinary sphincter (AUS) ZSI 375 PF (Zephyr
Surgical Implants, Geneva, CH).
METHODS: Retrospective, nonrandomised, multicentre study. From
December 2015 to June 2018, 28 male patients (PTS) underwent
device implantation.
Success rate definitions: dry (<=1 pad/day), improved (>=2 pads/day),
failed. Data collection of clinical chart and clinical interview and
exploration of the PTS was performed and introduced inan Excel
calculation worksheet. Statistical analysis was done through G-stat
2.0.
RESULTS: Median age: 72 years (range 56-83). Initial surgery: 14
open radical prostatectomies (RP) (50%), 8 laparoscopic RP (28.6%),
3 robot-assisted RP (10.7%), 2 transurethral resection of the prostate
(7.1%). 1 open adenomectomy (3.6%). External radiation therapy
(ERT) was performed in 16 PTS (and HIFU in one patient). Previous
anti-UI surgeries: 3 AMS-800(TM), 2 Virtue(TM), 2 botulinum toxin and
1 Urolastic(TM); 1 patient had first an Advance(TM) and a Flow-
Secure(TM) after. Previous cervicotomy in 10 PTS (twice in one
patient). Prior history of recurrent urinary tract infections (RUTI) in 4
PTS.
Median pad test: 1200 g. Urodynamic study: UI 100%, overactive
bladder 17.4%, detrusor underactivity during voiding 10.7%. No
intraoperative complications.
Hospital stay: 1-3 days. The device was activated 50 days after
surgery on average. Refill was performed in 12 PTS (1-3 times each),
median volume 0.4 ml. Nine of these PTS have received ERT
(including the patient after HIFU, 75%).
Continence rate: 19 PTS dry (67.9%), 7 PTS improved (25%), 2 PTS
failed (AUS explantation) (7.1%). Seven PTS with persistent urinary
incontinence had prior ERT (p=0.1359) and 3 had prior anti-UI
surgeries (p=0.4834).
Complications: Erosion with explantation in 2 PTS with prior RUTI and
cervicotomy (Clavien-Dindo IIIb) (7.1%); one patient had prior ERT.
Postoperative hydrocele in 1 patient, managed conservatively
(Clavien-Dindo I) (3.6%). Another patient required catheterization 48
hours after hospital discharge and cuff opening required surgical
exploration (Clavien-Dindo IIIa) (3.6%).
CONCLUSIONS: The refillable AUS ZSI 375 PF is a reliable alternative
with good continence results and low complication rate. Although
previous ERT might influence the achievement of complete
continence after implantation, it is not an absolute contraindication.
Careful information should be given to PTS with previous RUTI since
they seem to have a higher risk for device infection and explantation.
Source of Funding: None
(C) 2019 by the American Urological Association, Inc.
Language:
English.
Document Type:
Urodynamics/Lower Urinary Tract Dysfunction/Female Pelvic
Medicine: Male Incontinence: Therapy I (PD32): ABSTRACT Only.
Journal Subset:
Clinical Medicine.
ISSN:
0022-5347
DOI Number:
10.1097/01.JU.0000556144.33684.d2
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