V05-11: New adjustable artificial urethral sphincter (AUS) with an additional stress balloon further improves treatment outcome in male stress urinary incontinence (SUI)
The artificial urinary sphincter (AUS) became the gold standard to treat stress urinary incontinence (SUI) in the male. The reported success rate varied between 50 to 96%. Still, certain issues seem not to be solved. The recently released AUS Victor+ from Promedon® has been developed to solve these issues: faster reaction to stress, less episodes of urine loss, adjustable cuff to ensure the critical urethral closing pressure in order to avoid atrophy of the corpora spongiosum. We demonstrate the Victo+ surgical procedure and demonstrate its safety and efficacy.
We retrospectively reviewed data stored in a multi-center prospective database of 46 (average age:70±SD 7,5y) male patients with severe SUI. SUI resulted due to previous TURP, radical prostatectomy and even radiation followed by TURP related to prostate cancer. The implantation of the all-in-one Victor+AUS is performed in the lithotomy position through a midline perineal and inguinal incision. Patients were followed from 11 (0,9-20,9) months. The essential features of the operation are described. Primary successful operative measurements were defined as no complications and patient satisfaction. Successful treatment outcome was defined as no pad usage to reduction of pad usage > 50%.
No pre- and intra-operative complications were recorded. The operating time was 63 (55-78) min. After 6.5(5-7) weeks the patient returned for activation. 18/36 patients became continent with the initial filling, whereas others needed additional fluid to reach a satisfactory outcome. After the optimal filling of the Victo+AUS, the need for pads was reduced from 6,4±3,6 to 1,8±1,8 pads/day. Overall patient satisfaction was reported in 84% of the patients. Patients were also investigated regarding their leakage while coughing using the stress balloon. Leakage while coughing was not seen in any of patients.
The initial results of the new Victor+AUS appears that it can be safely and effectively performed with promising results.