Male Lower Urinary Tract Symptoms (LUTS) / Voiding Dysfunction
The artificial urinary sphincter (AUS) became the gold standard to treat stress urinary incontinence (SUI) in the male. The reported success rate varies between 50 to 96%. Still, certain issues seem not to be solved. The recently released AUS Victo+ 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 show its safety and efficacy.
We retrospectively reviewed data stored in a multi-center prospective database for 46 (average age:7 0± SD 7,5y) male patients with severe SUI. The causes of SUI were related to previous TURP, radical prostatectomy and even radiation related to prostate cancer.
In the lithotomy position through a midline perineal and inguinal incision, the one-piece Victo+AUS was implanted. Patients were followed from 11 (0,9 - 20,9) months. The essential features of operation are described. Primary successful operative measurements were defined as no complications and patient satisfaction. Successful treatment outcome was defined as no pad usage or reduction of pad usage > 50%.
No intraoperative complications occurred. Operative time was 63 (55-78) min. After 6 weeks the patient returned for activation. 18/36 patients became continent with the initial filling, whereas the other patients needed additional fluid to reach a satisfactory outcome. The need for pads reduced from 6,4 ± 3,6 to 1,8 ± 1,8 pads/day. Overall patient satisfaction was reported at 84%. The patients were also investigated with regard to their leakage while coughing. Related to the stress balloon, leakage while coughing was not seen in any of the patients.
The initial results of the Victo+ AUS demonstrates that it can be safely and effectively performed with promising results. The number of implants and the follow-up time is still small to make a final conclusion.