Artificial urinary sphincter revision with Quick Connects® versus suture−tie connectors: does technique make a difference?

Özet

Objective: To evaluate characteristics of artificial urinary sphincter (AUS) mechanical failures and com-pare outcomes based on the use of either suture−tied connections or Quick−Connects® (QC) for single-component revisions.Material and methods: A total of 46 patients underwent single-component AUS revisions following pri-mary AUS placement from January 1983 to January 2011 at our institute. Prior to 1996 all revision cases were performed with suture−tie connections and after that time we used QC for revisions. Device success was evaluated for a potential association with revision surgery including the type of connector used.Results: Forty-six patients underwent single-component revision surgery for primary device malfunction. In these cases, the tubing connections were performed using suture−tie connectors in 34 (74%), and QC in 12 (26%) cases. The median age was 68.8 years for suture- tie vs 70.6 years for QC (p=0.52). The median follow-up period after revision surgery was 24 months (IQR 7.2, 55.2). There was no statistically significant difference in 5 -year device survival rates between suture−tie and QC (36% vs. 61%; p=0.85) techniques. There were no cases of device infection or repeat mechanical failure at the connector among cases of revi-sion performed using QC, as compared to five device infections and four repeat mechanical failures among the suture-tie cohort.Conclusion: The use of QC for single-component AUS revision for mechanical failures appears to be safe, efficient and reliable. There is not enough evidence supporting the presence of an association between con-nector type with the risk of overall device failure.