[Comparison of penoscrotal and perineal approaches for implantation of an artificial urinary sphincter in man]. / Comparaison des voies d'abords peno-scrotales et perineales pour l'implantation d'un sphincter urinaire artificiel chez l'homme.

ABSTRACT

INTRODUCTION: Artificial urinary sphincter is considered the gold standard of treatment for male urinary incontinence because of intrinsic sphincter deficiency. The objective of our study was to compare the functional results and complications of the penoscrotal and perineal incision for the implantation of artificial urinary sphincter. MATERIAL AND METHODS: A retrospective, monocentric study comparing the perioperative and long-term results of primary implantation of an artificial urinary sphincter in men, performed by the penoscrotal or the perineal incision, was conducted in a French university hospital. RESULTS: Between April 2004 and February 2019, 175 patients were implanted (118 by penoscrotal incision and 57 by perineal incision) by 19 surgeons. Cuff placement approach depended on surgeon preference. The average follow-up was 34.2 ± 35.6 months. Cuff size was smaller in the penoscrotal group (4 [4;5] vs 4.5[4;5] p<0.001). At the end of follow-up, the rates of complete continence, social continence, reintervention for any reason, explantation, and revision was similar between the two groups. CONCLUSION: Long-term outcomes of penoscrotal and perineal artificial sphincter implantation were similar between the two groups. Prospective multicenter studies are needed to confirm these results.