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Kutchukian S, Gondran-Tellier B, Dinh A, Robin H, Bigot P, Françot M, de Vergie S, Rigaud J, Chapuis M, Brureau L, Jousseaume C, Karray O, Kosseifi FT, Borojeni S, Descazeaud A, Chicaud M, Asare HJ, Gaullier M, Poussot B, Tricard T, Baboudjian M, Lechevallier É, Delpech PO, Ayoub E, Héloïse Ducousso H, Bernardeau S, Bruyère F, Vallée M. Asymptomatic Bacteriuria and Urological Surgery: Risk Factor or Not? Results from the National and Multicenter TOCUS Database. J Urol 2024:101097JU0000000000004047. [PMID: 38753587 DOI: 10.1097/ju.0000000000004047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/05/2024] [Indexed: 05/18/2024]
Abstract
PURPOSE Current guidelines recommend screening and treatment of asymptomatic bacteriuria prior to all urological surgeries breaching the mucosa. But few evidence is supporting this recommendation. At least, risk stratification for postoperative urinary tract infection to support this strategy is lacking. The aim of this study was to define the associated factors for postoperative febrile infectious complications (urinary tract infection or surgical site infection) in urological surgery. MATERIALS AND METHODS We conducted a retrospective, multicentric study including all consecutive patients undergoing any urological surgery with preoperative urine culture. The primary outcome was the occurrence of a urinary tract infection or surgical site infection occurring within 30 days after surgery. RESULTS rom 2016 to 2023, in 10 centers, 2389 patients were included with 838 (35%) positive urine cultures (mono/bi/polymicrobial). Postoperative infections occurred in 106 cases (4.4%), of which 44 had negative urine cultures (41%), 42 had a positive mono/bi-microbial urine cultures (40%) and 20 had a polymicrobial urine cultures (19%). In multivariable analysis, urinary tract infections during the previous 12 months of surgery (OR 3.43; CI 95 2.07-5.66; P < .001), monomicrobial/bimicrobial preoperative urine culture (OR 3.68; CI 95 1.57-8.42; P 0.02), polymicrobial preoperative urine culture (OR 2.85; CI 95 1.52-5.14; P < .001), operative time (OR 1.09; CI 95 1.04-1.15; P < .001) were independent associated factors for postoperative febrile infections. CONCLUSIONS Positive urine culture, including preoperative polymicrobial urine culture, prior to urological surgery was associated with postoperative infection. Additionally, patients experiencing infectious complications also had a higher incidence of other complications. The effectiveness of systematic preventive antibiotic therapy for a positive urine culture has not been conclusively established.
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Affiliation(s)
- Stessy Kutchukian
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, F-86000 Poitiers, France
| | - Bastien Gondran-Tellier
- Département d'urologie Centre Hospitalier Universitaire, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Aurélien Dinh
- Service de maladies infectieuses, Centre Hospitalier Universitaire, R. Poincaré, APHP, Garches, Université Versailles Paris Saclay, IHU PROMETHEUS
- Membre du comité d'infectiologie de l'Association Française d'Urologie (CIAFU)
| | - Humphrey Robin
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, F-86000 Poitiers, France
| | - Pierre Bigot
- Département d'urologie, Centre Hospitalier Universitaire, Angers, France
| | - Marc Françot
- Département d'urologie, Centre Hospitalier Universitaire, Nantes, France
| | - Stéphane de Vergie
- Département d'urologie, Centre Hospitalier Universitaire, Nantes, France
| | - Jérôme Rigaud
- Département d'urologie, Centre Hospitalier Universitaire, Nantes, France
| | - Mathilde Chapuis
- Département d'urologie, Centre Hospitalier Universitaire, Guadeloupe, France
| | - Laurent Brureau
- Département d'urologie, Centre Hospitalier Universitaire, Guadeloupe, France
| | - Camille Jousseaume
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, F-86000 Poitiers, France
| | - Omar Karray
- Département d'urologie, Centre Hospitalier, Pontoise, France
| | - Fares T Kosseifi
- Département d'urologie, Centre Hospitalier Universitaire, Paris Saint Joseph, France
| | - Shahed Borojeni
- Département d'urologie, Centre Hospitalier Universitaire, Paris Saint Joseph, France
| | | | - Marie Chicaud
- Département d'urologie, Centre Hospitalier Universitaire, Limoges, France
| | - Harrison-Junior Asare
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, F-86000 Poitiers, France
| | - Maxime Gaullier
- Département d'urologie, Centre Hospitalier Universitaire, Strasbourg, France
| | - Baptiste Poussot
- Département d'urologie, Centre Hospitalier Universitaire, Strasbourg, France
| | - Thibault Tricard
- Département d'urologie, Centre Hospitalier Universitaire, Strasbourg, France
| | - Michael Baboudjian
- Département d'urologie Centre Hospitalier Universitaire, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Éric Lechevallier
- Département d'urologie Centre Hospitalier Universitaire, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Pierre-Olivier Delpech
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, F-86000 Poitiers, France
| | - Elias Ayoub
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, F-86000 Poitiers, France
| | - Héloïse Héloïse Ducousso
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, F-86000 Poitiers, France
| | - Simon Bernardeau
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, F-86000 Poitiers, France
| | - Franck Bruyère
- Membre du comité d'infectiologie de l'Association Française d'Urologie (CIAFU)
- Département d'urologie, Centre Hospitalier Universitaire, Tours, France
| | - Maxime Vallée
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, F-86000 Poitiers, France
- Membre du comité d'infectiologie de l'Association Française d'Urologie (CIAFU)
- Université de Poitiers, unité INSERM U1070, PHAR2, F-86000 Poitiers, France
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Ayoub E, Kutchukian S, Bigot P, Dinh A, Gondran-Tellier B, Robin H, Françot M, de Vergie S, Rigaud J, Chapuis M, Brureau L, Jousseaume C, Karray O, Kosseifi FT, Borojeni S, Descazeaud A, Asare HJ, Gaullier M, Poussot B, Tricard T, Baboudjian M, Lechevallier É, Delpech PO, Ducousso H, Bernardeau S, Bruyère F, Vallée M. Asymptomatic bacteriuria prior to partial and radical nephrectomy: To screen or not to screen? Results from the national and multicenter TOCUS database. World J Urol 2024; 42:179. [PMID: 38507063 DOI: 10.1007/s00345-024-04853-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/06/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION In the era of increased bacterial resistance, the main strategy is to reduce the prescription of antibiotics when possible. Nowadays, it is highly recommended to screen for asymptomatic bacteriuria (ABU), prior to urological surgery with potential mucosal breach or urine exposure. Screening and treating urinary colonization is a strategy widely adopted before radical and partial nephrectomy but without any evidence. Our main end point in this study is to analyze the relationship between preoperative urine culture and the risk of postoperative febrile urinary tract infection (UTI) or surgical-site infection (SSI) in partial or radical nephrectomy patients. METHODS We conducted a multicenter retrospective cohort study between January 2016 and January 2023 in 11 French tertiary referral hospitals (TOCUS database). We collected the data for 269 patients including several pre-, intra-, and post-operative variables that could potentially increase the risk of postoperative UTI and SSI including preoperative urinary culture results. RESULTS The incidence rate of postoperative UTI and SSI was 8.9% in our study. After conducting a logistic multivariate analysis, a propensity score matching analysis, and a subgroup analysis, we found no significant correlation between the urine culture and the postoperative UTI risk [OR = 1.2 (0.5-2.7) (p = 0.7)]. Only the postoperative non-infectious complications were related to a higher risk of postoperative UTI [OR = 12 (4-37), p < 0.001)]. CONCLUSION Our research shows that screening and treating for ABU prior to radical or partial nephrectomy seems to be unnecessary to prevent postoperative UTI and SSI.
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Affiliation(s)
- Elias Ayoub
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France.
| | - Stessy Kutchukian
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Pierre Bigot
- Département d'urologie Centre Hospitalier Universitaire, Angers, France
| | - Aurélien Dinh
- Service de maladies infectieuses, Centre Hospitalier Universitaire, R. Poincaré, APHP, GarchesUniversité Versailles Paris Saclay, IHU PROMETHEUS, Paris, France
- Membre du comité d'infectiologie de l'Association Française d'Urologie (CIAFU), Paris, France
| | - Bastien Gondran-Tellier
- Département d'urologie Centre Hospitalier Universitaire, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Humphrey Robin
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Marc Françot
- Département d'urologie Centre Hospitalier Universitaire, Nantes, France
| | | | - Jérôme Rigaud
- Département d'urologie Centre Hospitalier Universitaire, Nantes, France
| | - Mathilde Chapuis
- Département d'urologie Centre Hospitalier Universitaire, Guadeloupe, France
| | - Laurent Brureau
- Département d'urologie Centre Hospitalier Universitaire, Guadeloupe, France
| | - Camille Jousseaume
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Omar Karray
- Département d'urologie Centre Hospitalier, Pontoise, France
| | - Fares T Kosseifi
- Département d'urologie Centre Hospitalier Universitaire, Paris Saint Joseph, France
| | - Shahed Borojeni
- Département d'urologie Centre Hospitalier Universitaire, Paris Saint Joseph, France
| | | | - Harrison-Junior Asare
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Maxime Gaullier
- Département d'urologie Centre Hospitalier Universitaire, Strasbourg, France
| | - Baptiste Poussot
- Département d'urologie Centre Hospitalier Universitaire, Strasbourg, France
| | - Thibault Tricard
- Département d'urologie Centre Hospitalier Universitaire, Strasbourg, France
| | - Michael Baboudjian
- Département d'urologie Centre Hospitalier Universitaire, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Éric Lechevallier
- Département d'urologie Centre Hospitalier Universitaire, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Pierre-Olivier Delpech
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Héloïse Ducousso
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Simon Bernardeau
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Franck Bruyère
- Membre du comité d'infectiologie de l'Association Française d'Urologie (CIAFU), Paris, France
- Département d'urologie Centre Hospitalier Universitaire, Tours, France
| | - Maxime Vallée
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
- Membre du comité d'infectiologie de l'Association Française d'Urologie (CIAFU), Paris, France
- Université de Poitiers, unité INSERM U1070, PHAR2, 86000, Poitiers, France
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Poussot B, Sauvinet G, Romain B. Hybrid Sugarbaker technique for parastomal hernia repair (with video). J Visc Surg 2022; 159:433-435. [PMID: 35701300 DOI: 10.1016/j.jviscsurg.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- B Poussot
- Service de chirurgie générale et digestive, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg Cedex, France
| | - G Sauvinet
- Service de chirurgie générale et digestive, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg Cedex, France
| | - B Romain
- Service de chirurgie générale et digestive, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg Cedex, France; Streinth Lab (Stress Response and Innovative Therapies), Strasbourg University, Inserm UMR_S 1113 IRFAC (Interface Recherche Fondamental et Appliquée à la Cancérologie), 67200 Strasbourg, France.
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Rossi J, Cazzato RL, de Marini P, Auloge P, Autrusseau PA, Dalili D, Tricard T, Poussot B, Garnon J, Lang H, Gangi A. Safety and Oncologic Outcomes of Percutaneous Cryoablation of Renal Cell Carcinoma Recurrences in the Ipsilateral Kidney Following Partial Nephrectomy. Cardiovasc Intervent Radiol 2022; 45:656-664. [PMID: 35274173 DOI: 10.1007/s00270-022-03079-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 12/25/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE To retrospectively investigate the safety and oncological outcomes of cryoablation performed on residual/recurring renal cell carcinoma (RCC) in the ipsilateral kidney following partial nephrectomy (PN). MATERIALS AND METHODS Data dealing with patients', RCC, procedure (including the length of the hospital stay), and follow-up (technical efficacy [TE], local tumor progression-free survival [LTPFS], disease-free survival [DFS], metastasis-free survival [MFS], cancer-specific survival (CSS), and overall survival [OS]) were retrospectively collected and analyzed. RESULTS Between January 2008 and November 2020, 21 consecutive patients (17 [81%] men; 4 [19%] women; median age 68 years; range 43-82) underwent cryoablation due to residual/recurring RCC in the PN site (15 patients) or de-novo RCC (6 patients) in the ipsilateral kidney. Median tumor size was 2.2 cm (mean 2.3 cm; range 0.8-4; interquartile range [IQR] 1.9-3). There were two (2/21; 10%) minor self-limiting hemorrhagic complications, both occurring in the group of patients with RCC in the PN site. Median hospital stay was 2 days (mean 2.1; range 1-5; IQR 2-2). TE was 100% (21/21 patients), and 10-year estimates of LTPFS, MFS and DFS were 74.1% (95% confidence intervals [CI] 56.8-96.7%), 36.4% (95% CI 14.2-93.8%), and 43.5% (95% CI 21.9-86.4%), respectively. CSS and OS were 100% at the last available follow-up (median 56 months; mean 67.4; range: 12-147; IQR:34-95). CONCLUSION Cryoablation in patients with residual/recurring RCC following PN is safe and results in high 10-year estimates of LTPFS.
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Affiliation(s)
- Julien Rossi
- Department of Imaging, Service d'Imagerie, Lyon Sud Hospital, University Hospital of Lyon, Hospices Civils de Lyon, Lyon, France. .,Claude-Bernard University of Lyon, 165 chemin du Grand Revoyet, 69495, Pierre-Bénite, Lyon, France.
| | - Roberto Luigi Cazzato
- Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France.,Department of Medical Oncology, Strasbourg-Europe Cancer Institute (ICANS), Strasbourg, France
| | - Pierre de Marini
- Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - Pierre Auloge
- Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France
| | | | - Danoob Dalili
- Epsom and St Helier University Hospitals, London, UK
| | - Thibault Tricard
- Department of Urology, University Hospital of Strasbourg, Strasbourg, France
| | - Baptiste Poussot
- Department of Urology, University Hospital of Strasbourg, Strasbourg, France
| | - Julien Garnon
- Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - Hervé Lang
- Epsom and St Helier University Hospitals, London, UK
| | - Afshin Gangi
- Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France.,School of Biomedical Engineering and Imaging Sciences, King's College London, Strand, WC2R 2LS, London, UK
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El Akri M, Bentellis I, Tricard T, Brierre T, Cousin T, Dupuis H, Hermieu N, Gaillard V, Poussot B, Robin D, Pitout A, Bertrand-Leon P, Chevallier D, Bruyere F, Biardeau X, Monsaint H, Corbel L, Saussine C, Hermieu J, Lecoanet P, Capon G, Cornu JN, Game X, Ruffion A, Peyronnet B. Transcorporal vs. bulbar artificial urinary sphincter implantation in male patients with fragile urethra. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00664-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Robin D, Peyronnet B, Bentellis I, El-Akri M, Cornu JN, Brierre T, Cousin T, Gaillard V, Poussot B, Dupuis H, Tricard T, Hermieu N, Pitout A, Beraud F, Chevallier D, Bruyere F, Biardeau X, Monsaint H, Corbel L, Hermieu JF, Lecoanet P, Capon G, Saussine C, Gamé X, Léon P. Sphincter urinaire artificiel chez les patients présentant une incontinence urinaire après High Intensivity Focused Ultrasound Therapy. Prog Urol 2022; 32:284-290. [DOI: 10.1016/j.purol.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
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Mamane J, Sanchez S, Lellouch AG, Gaillard V, Poussot B, Tricard T, Saussine C, Brierre T, Game X, Beraud F, Biardeau X, Bruyere F, Robin D, El-Akri M, Chevallier D, Durand M, Bentellis I, Cousin T, Capon G, Cornu JN, Dupuis H, Monsaint H, Corbel L, Hermieu N, Hermieu JF, Pitout A, Lecoanet P, Peyronnet B, Leon P. Impact of radiation therapy on artificial urinary sphincter implantation in male patients: A multicenter study. Neurourol Urodyn 2021; 41:332-339. [PMID: 34816473 DOI: 10.1002/nau.24825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 09/22/2021] [Accepted: 10/12/2021] [Indexed: 11/11/2022]
Abstract
AIMS To evaluate the impact of an history of radiation therapy on the outcomes of artificial urinary sphincter (AUS) implantation in male patients. METHODS The charts of all patients who underwent AUS implantation for stress urinary incontinence (SUI) after prostate surgery in thirteen centers between 2004 and 2020 were retrospectively reviewed. We excluded patients with neurogenic SUI. Continence rates and incidence of complications, revision and cuff erosion were evaluated. The outcomes in irradiated men were compared to those of non irradiated men. RESULTS A total of 1277 patients who had an AUS met the inclusion criteria with a median age of 70 years, of which 437 had an history of prior radiotherapy. There was no difference in comorbidities. In irradiated patients, postoperative social continence, urethral atrophy and infection rates were respectively 75.6%, 2.4% and 9.5% and 76.8%, 5.4%, and 5.8% in nonirradiated men (respectively, p = 0.799, p = 0.128, p = 0.148). There were more urethral erosion in irradiated male patients. After a mean follow up of 36.8 months, the explantation free survival was poorer in irradiated patients (p = 0.001). CONCLUSION These data suggest that pelvic radiotherapy before AUS adversely affect device survival with and increased greater occurrence of infection-erosion and therefore of explantation.
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Affiliation(s)
- Jordan Mamane
- Department of Urology, University of Reims, Reims, France
| | - Stéphane Sanchez
- Department of Medical Information Evaluation and Performance, Troyes Hospital, Troyes, France
| | - Alexandre G Lellouch
- Department of Plastic Reconstructive Surgery, European Georges Pompidou Hospital, Paris, France.,Division of Plastic and Reconstructive Surgery, and Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Victor Gaillard
- Department of Urology, University of Strasbourg, Strasbourg, France
| | - Baptiste Poussot
- Department of Urology, University of Strasbourg, Strasbourg, France
| | - Thibault Tricard
- Department of Urology, University of Strasbourg, Strasbourg, France
| | | | - Thibaut Brierre
- Department of Urology, University of Toulouse, Toulouse, France
| | - Xavier Game
- Department of Urology, University of Toulouse, Toulouse, France
| | - Florian Beraud
- Department of Urology, University of Lille, Lille, France
| | | | - Franck Bruyere
- Department of Urology, University of Tours, Tours, France
| | - Damien Robin
- Department of Urology, University of Reims, Reims, France
| | - Mehdi El-Akri
- Department of Urology, University of Nice, Nice, France
| | | | | | - Imad Bentellis
- Department of Urology, University of Rennes, Rennes, France
| | - Tiffany Cousin
- Department of Urology, University of Bordeaux, Bordeaux, France
| | - Grégoire Capon
- Department of Urology, University of Bordeaux, Bordeaux, France
| | | | - Hugo Dupuis
- Department of Urology, University of Rouen, Rouen, France
| | | | - Luc Corbel
- Department of Urology, Clinic Plérin, Plérin, France
| | | | | | - Alice Pitout
- Department of Urology, University of Nancy, Nancy, France
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Dupuis HGA, Bentellis I, El-Akri M, Brierre T, Cousin T, Gaillard V, Poussot B, Tricard T, Hermieu N, Robin D, Pitout A, Beraud F, Durand M, Chevallier D, Bruyere F, Biardeau X, Monsaint H, Corbel L, Leon P, Hermieu JF, Lecoanet P, Capon G, Game X, Saussine C, Peyronnet B, Cornu JN. Early Efficacy and Safety Outcomes of Artificial Urinary Sphincter for Stress Urinary Incontinence Following Radical Prostatectomy or Benign Prostatic Obstruction Surgery: Results of a Large Multicentric Study. Eur Urol Focus 2021; 8:1053-1059. [PMID: 34548254 DOI: 10.1016/j.euf.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/10/2021] [Accepted: 09/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Artificial urinary sphincter (AUS) is the gold standard for the management of moderate to severe stress urinary incontinence (SUI) in the male population. While outcomes of this device in postprostatectomy incontinence (PPI) are widely described, those obtained for incontinence after benign prostatic obstruction (BPO) surgery remains poorly explored. OBJECTIVE To compare continence outcomes after AUS implantation in a PPI population with those obtained in men incontinent after BPO surgery. DESIGN, SETTING, AND PARTICIPANTS A retrospective review of all cases of AUS implantation between 2005 and 2020 in 16 different French centers was conducted. Only patients with primary implantation whose indication was moderate to severe SUI after prostatectomy or BPO surgery were included (excluding those with a history of radiation therapy, brachytherapy, cystectomy, high-intensity focused ultrasound therapy, or neurogenic disease). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary endpoint was the rate of social continence (zero or one pad per day) at 3 mo. Complications were also noted within 90 d of implantation. RESULTS AND LIMITATIONS A total of 417 patients were included in the PPI group and 50 in the BPO surgery group. Social continence rates at 3 mo were similar between the groups (79% vs 72%, p = 0.701). Complication rate was significantly higher in the BPO group (8% vs 18%, p = 0.044). The same was found for the Clavien-Dindo type 2 complication rate (20.6% vs 44.4%, p = 0.026). The retrospective nature and lack of precise definition of incontinence are the main limitations of this study. CONCLUSIONS This multicentric study strengthens the position of AUS as gold standard for SUI after radical prostatectomy. Comparable efficacy results were found for incontinence after BPO surgery, with nevertheless a higher rate of complications. PATIENT SUMMARY Artificial urinary sphincter represents the gold standard for the treatment of moderate to severe stress urinary incontinence. Efficacy results are comparable between postprostatectomy incontinence and incontinence after benign prostatic obstruction surgery.
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Affiliation(s)
| | | | - Mehdi El-Akri
- Department of Urology, University of Rennes, Rennes, France
| | - Thibaut Brierre
- Department of Urology, University of Toulouse, Toulouse, France
| | - Tiffany Cousin
- Department of Urology, University of Bordeaux, Bordeaux, France
| | - Victor Gaillard
- Department of Urology, University of Strasbourg, Strasbourg, France
| | - Baptiste Poussot
- Department of Urology, University of Strasbourg, Strasbourg, France
| | - Thibault Tricard
- Department of Urology, University of Strasbourg, Strasbourg, France
| | | | - Damien Robin
- Department of Urology, University of Reims, Reims, France
| | - Alice Pitout
- Department of Urology, University of Nancy, Nancy, France
| | - Florian Beraud
- Department of Urology, University of Lille, Lille, France
| | | | | | - Franck Bruyere
- Department of Urology, University of Tours, Tours, France
| | | | | | - Luc Corbel
- Department of Urology, Clinique Plérin, Plérin, France
| | | | | | | | - Grégoire Capon
- Department of Urology, University of Bordeaux, Bordeaux, France
| | - Xavier Game
- Department of Urology, University of Toulouse, Toulouse, France
| | | | | | - Jean-Nicolas Cornu
- Department of Urology, Charles Nicolle University Hospital, Rouen, France
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Bentellis I, El-Akri M, Cornu JN, Brierre T, Cousin T, Gaillard V, Poussot B, Dupuis H, Hermieu N, Robin D, Pitout A, Beraud F, Bertrand-Leon P, Chevallier D, Bruyere F, Biardeau X, Monsaint H, Corbel L, Hermieu JF, Lecoanet P, Capon G, Game X, Saussine C, Durand M, Peyronnet B. Impact of the center volume activity on the results of artificial urinary sphincter in non-neurological male patients. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00506-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Bentellis I, El-Akri M, Cornu J, Brierre T, Cousin T, Gaillard V, Poussot B, Dupuis H, Hermieu N, Robin D, Pitout A, Beraud F, Bertrand-Leon P, Chevallier D, Bruyere F, Biardeau X, Monsaint H, Corbel L, Hermieu J, Lecoanet P, Capon G, Game X, Saussine C, Durand M, Peyronnet B. Prevalence and risk factors of artificial urinary sphincter revision in non-neurological male patients. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00507-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Mamane J, Sanchez S, Lellouch A, El-Akrhi M, Cousin T, Capon G, Bentellis I, Chevallier D, Durand M, Robin D, Cornu JN, Dupuis H, Gaillard V, Poussot B, Tricard T, Saussine C, Ruffion A, Pitout A, Lecoanet P, Hermieu N, Hermieu JF, Peyronnet B, Bertrand-Leon P. Outcomes of artificial urinary sphincter implantation in irradiated patients: A multicenter study. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00508-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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El-Akri M, Bentellis I, Tricard T, Brierre T, Cousin T, Depuis H, Hermieu N, Robin D, Poussot B, Bertrand P, Chevallier D, Bruyère F, Saussine C, Lecoanet P, Capon G, Hermieu J, Cornu J, Gamé X, Ruffion A, Peyronnet B. Comparaison de l’implantation transcaverneuse d’un sphincter artificiel urinaire artificiel en primo-implantation vs en réimplantation. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bentellis I, El-Akri M, Tricard T, Brierre T, Cousin T, Dupuis H, Hermieu N, Poussot B, Pitout A, Bertrand-Léon P, Chevallier D, Bruyère F, Saussine C, Hermieu J, Lecouanet P, Ruffion A, Capon G, Cornu J, Gamé X, Peyronnet B. Facteurs de risque de révision de sphincter urinaire artificiel chez l’homme selon la cause. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mohamedatni Y, Fergani B, Laheurte JM, Poussot B. New methodology for the short range localization of UHF RFID tags using a linear uniform array. RFT 2019. [DOI: 10.3233/rft-180152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Y. Mohamedatni
- LISIC Laboratory, University of Sciences and Technology Houari Boumediene, B.P 32, Al Alia, Bab Ezzouar, Algiers, Algeria
| | - B. Fergani
- LISIC Laboratory, University of Sciences and Technology Houari Boumediene, B.P 32, Al Alia, Bab Ezzouar, Algiers, Algeria
| | - J.-M. Laheurte
- ESYCOM Laboratory (EA 2552), Paris-Est University, F-77454 Marne-la-Vallée, France
| | - B. Poussot
- ESYCOM Laboratory (EA 2552), Paris-Est University, F-77454 Marne-la-Vallée, France
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