Continence and quality of life after artificial urinary sphincter implantation in patients with neurological urinary tract disorder: A narrative review over the past 20 years.

INTRODUCTION

This systematic review assesses two decades of literature about continence and quality of life (QoL) with neurogenic stress urinary incontinence (N-SUI).

METHODS

We performed a non-systematic literature review using the PubMed Database to identify articles related to continence and quality of life in patients with N-SUI using after artificial urinary sphincter (AUS).

RESULTS

Quality of life after AUS in patients with NSUI is rarely assessed in series. In this review, we found 21 series of interest in which only 6 report results on QoL. Most patients achieved social continence (75 to 90%) or total dryness (71 to 75%). Restoring continence provides an important benefit. Among the patients, 78.8% reported to be "very much improved". In women, the disappearance of coital incontinence was the most significant factor in improving sexual QoL. A minority reported a deterioration in their sexual life due to the physical presence of the pump. However, AUS in patients N-SUI with is characterized by a significant need for revisions. Urethral erosion and infection are the primary causes for definitive device removal more often with the use of clean intermittent catheterization (CIC), due to urethral trauma. Robot-assisted techniques have further improved safety by reducing perioperative complications and shortening hospital stay.

CONCLUSION

The AUS provides long-term high rates of social continence. QoL and intimacy are under reported in the literature. Future research must prioritize standardized QoL and sexuality questionnaires for neuro-urological populations to report the impact of the implant on these life domains.