Freton L, et al. - Physicians designed this study to compare the outcomes of the adjustable continence therapy device with those of the artificial urinary sphincter (AUS) American Medical System 800 in the treatment of stress urinary incontinence (SUI) because of sphincter deficiency in women. Compared to the ACT implantation, AUS implantation was correlated with better functional outcomes in female patients with SUI due to intrinsic sphincter deficiency. However, AUS implantation had a higher intraoperative complications rate, longer operative time, and a longer stay.

Methods

• The physicians included all the women who underwent surgical treatment for SUI due to intrinsic sphincter deficiency from 2007 to 2017 in a single-center retrospective study.
• The functional outcome was the primary endpoint.
• They compared perioperative functional parameters of the 2 groups.

Results

• The physicians performed ACT implantation in 25 patients and AUS implantation in 36 patients.
• In the AUS group, patients were found to be younger (62.9 vs 70.4 years; p=0.03) with less comorbidity (ASA Score = 3 in 12.1% vs 33.3%; p=0.005).
• In the ACT group, operative time and hospital stay were shorter (45.7 vs 206.1 min; p < 0.001; 1.7 vs 7 days; p < 0.001 respectively).
• A higher rate of intraoperative complications was noted in the AUS group (47% vs 8%; p < 0.001).
• However, the rates of postoperative complications were similar between both groups.
• The ACT was correlated with an increased risk of urinary retention (20% vs 2.8%; p=0.04).
• In this study, outcomes were in favor of AUS for: Decrease in USP stress incontinence subscore (-7.6 vs -3.2; p < 0.001), number of pads per 24 h (- 4.6 vs -2.3; p=0.002), PGII scale (PGII = 1: 61.1% vs 12%; p < 0.001), and cure rate (71.4% vs 21.7%; p < 0.001).