International variation in artificial urinary sphincter use Journal Article


Authors: Matsushita, K.; Chughtai, B. I.; Maschino, A. C.; Lee, R. K.; Sandhu, J. S.
Article Title: International variation in artificial urinary sphincter use
Abstract: To analyze international trends in artificial urinary sphincter (AUS) use, indications for placement, and application by gender. We conducted a retrospective review of data derived from patient information forms sent to American Medical Systems. There were 86 140 unique cases from March 1975 through December 2008, including all indications. AUS use increased worldwide from 1975 (90 procedures) through 2008 (4818 procedures). In 2008, patients with postprostatectomy incontinence (PPI) accounted for 61% (2907/4751) of AUS use compared to 12% (8/66) in 1975. Artificial urinary sphincter annual implant rates in women were much lower than in men, decreasing from 298 procedures in 1990 to 67 in 2008. Artificial urinary sphincter implants in the United States for men alone accounted for the majority (62%, 2995/4818) of worldwide artificial urinary sphincter use in 2008. Conversely, artificial urinary sphincter use has recently started declining in other areas, including South America and Canada. Frequency of artificial urinary sphincter surgery varied dramatically from less than 0.01 per 100 000 population in Brazil to 0.99 in the United States. Of surgeons performing artificial urinary sphincter implants in 2008, case volumes in and outside of the United States were similarly low: 56% in the United States and 52% outside the United States performed only 1 artificial urinary sphincter implant, whereas 76% in the United States and 73% outside the United States did fewer than 3. Artificial urinary sphincter use has continued to increase internationally over the study period, especially for patients with PPI. However, artificial urinary sphincter use exhibits considerable regional variation, and most surgeons performed very low annual case volumes of implants. © 2012 Published by Elsevier Inc.
Keywords: retrospective studies; united states; physician's practice patterns; medical record review; retrospective study; patient information; canada; internationality; incontinence; south america; bladder sphincter prosthesis; urinary sphincter, artificial; postprostatectomy incontinence
Journal Title: Urology
Volume: 80
Issue: 3
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2012-09-01
Start Page: 667
End Page: 672
Language: English
DOI: 10.1016/j.urology.2012.04.065
PROVIDER: scopus
PUBMED: 22925241
DOI/URL:
Notes: --- - "Export Date: 1 October 2012" - "CODEN: URGYA" - "Source: Scopus"
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MSK Authors
  1. Jaspreet Sandhu
    114 Sandhu
  2. Richard Kao Lee
    4 Lee