Bladder neck artificial urinary sphincter (BN AUS) for recurrent urodynamically proven stress urinary incontinence and mixed urinary incontinence - outcomes of implantation
BAUS ePoster online library. Fenner V. Jun 26, 2018; 211332
Ms. Vanessa Fenner
Ms. Vanessa Fenner
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Abstract
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Introduction: To assess the outcome of BN AUS insertion for recurrent or complex primary urodynamically proven stress urinary incontinence (SUI) and stress-predominant mixed urinary incontinence (MUI).

Patients and Methods: We retrospectively reviewed a prospectively collected database of women having BN AUS implantation by two surgeons for SUI and MUI. The type and aetiology of the incontinence, previous surgery, the type of procedure and the outcome in terms of cure and complications were recorded.

Results: 50 women with median age 50.5 years (range 27-69) had BN AUS implantation, as above, between 2006 and 2016. Of these, 34 had primary implants, 12 had a device replacement following mechanical failure and 4 had a new implant following previous explantation of an earlier device for erosion. The aetiology was neurological in 17, recurrent stress urinary incontinence in 16, epispadias in 6, pelvic fracture urethral injury in 4, bilateral single ectopic ureter in 3, urethrovaginal fistula in 1, augmentation urethroplasty in 1, congenital Mullerian anomaly in 1 and undiversion in 1. 43 had had previous surgery including cystoplasty, undiversion, urethroplasty, urethrovaginal fistula repair and anti-incontinence surgery. The results and complications are listed in the table below.

Conclusion: BN AUS implantation has a 6% infection/erosion rate and a 22% chronic infection erosion rate leading to device explanation. For the 78% of women with functioning devices, incontinence is cured in 85% and improved in a further 10%. Only 2 patients remain wet and both have congenital anatomical abnormalities of the lower urinary tract.
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