Deterioration of cystometric parameters following the artificial urinary sphincter procedure in patients with spinal cord lesion: a retrospective analysis.

Abstract

Purpose: The artificial urinary sphincter (AUS) remains the gold standard to treat stress urinary incontinence related to sphincter insufficiency in patients with neurogenic lower urinary tract dysfunction (NLUTD). This study aims to assess the incidence of de novo neurogenic detrusor overactivity or low bladder compliance after AUS implantation in adult spinal cord injured patients.

Methods: Retrospective observational study, descriptive by analysis of the medical records of patients followed in a department of Neuro-Urology from January 01, 2003 to March 31, 2023. The procedures followed were in accordance with the regulations of the Clinical Research and Ethics Committee and the Declaration of Helsinki of the World Medical Association.

Results: Thirty-nine patients with spinal cord lesion were included. The incidence of de novo low bladder compliance or neurogenic detrusor overactivity with high pressure (≥ 40 cmH₂O) was 48.72% with a median onset delay of 11 months (IQR 8-55.5) after surgery. The need for medical treatment for the detrusor overactivity prior to AUS insertion was associated with deterioration of cystometric parameters at 2 years (p = 0.032).

Conclusion: This study reveals an important incidence of deterioration in cystometric parameters after AUS implantation in patients with spinal cord injury. A larger prospective study is needed to confirm these results and to identify risk factors.