Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: Systematic review and meta-analysis
Background and objective:: Male stress urinary incontinence (UI) remains a serious problem associated with a significant quality of life reduction. The aim of this study is to determine the safety and effectiveness of artificial urinary sphincter (AUS) and male slings (MS) for stress UI in men. Evid...
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| Language: | English |
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Elsevier
2024-12-01
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| Series: | Continence Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772974524000243 |
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| author | Bagrat Grigoryan George Kasyan Roman Shapovalenko Dmitry Pushkar |
| author_facet | Bagrat Grigoryan George Kasyan Roman Shapovalenko Dmitry Pushkar |
| author_sort | Bagrat Grigoryan |
| collection | DOAJ |
| description | Background and objective:: Male stress urinary incontinence (UI) remains a serious problem associated with a significant quality of life reduction. The aim of this study is to determine the safety and effectiveness of artificial urinary sphincter (AUS) and male slings (MS) for stress UI in men. Evidence acquisition:: Inclusion criteria: randomized/non-randomized trials evaluating adult men with stress UI. Exclusion criteria: repeated SUI surgery, combined conservative interventions and pharmacological treatment. The electronic databases were searched up to January 2024. The systematic review was conducted according to PICO framework and PRISMA 2020 guidelines and was registered in PROSPERO. The risk of bias was evaluated using the tools recommended by the Cochrane Society. Evidence synthesis:: Thirteen clinical trials were included in the systematic review, and 11 in the meta-analysis. There was no statistically significant difference in the improvement rate between AUS and MS (RR = 0.93, 95% CI: [0.85, 1.02], p= 0.13). MS showed statistically significant fewer infectious complication (RR = 3.26, 95% CI: [1.97, 5.39], p<0.00001), device explantation (RR = 3.29, 95% CI: [2.46, 4.41], p<0.00001), surgical revision (RR = 2.27, 95% CI: [1.60, 3.20], p<0.00001), urinary retention (RR = 0.04, 95% CI: [0.01, 0.07], p = 0.004) rates and operation time (RR = 0.93, 95% CI: [0.85, 1.02], p = 0.13) compared with AUS. Conclusion:: AUS demonstrates a comparable improvement level to MS. The operation time, infectious complication, device explantation, urinary retention, and surgical revision rates were lower in MS. More randomized and prospective studies with long-term follow-up will further increase confidence in the choice between AUS and MS for male UI treatment. |
| format | Article |
| id | doaj-art-41b1e757fa4d412890347166494bfdaa |
| institution | OA Journals |
| issn | 2772-9745 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Continence Reports |
| spelling | doaj-art-41b1e757fa4d412890347166494bfdaa2025-08-20T02:35:41ZengElsevierContinence Reports2772-97452024-12-011210007010.1016/j.contre.2024.100070Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: Systematic review and meta-analysisBagrat Grigoryan0George Kasyan1Roman Shapovalenko2Dmitry Pushkar3Moscow Urology Center, Botkin Hospital, Moscow, Russian Federation; Urology Department of Russian University of Medicine, Moscow, Russian Federation; Correspondence to: Urology Department of Russian University of Medicine, Moscow Urology Center, Botkin Hospital, 2nd Botkinsky pr-d, 5, Moscow, 125284, Russian Federation.Moscow Urology Center, Botkin Hospital, Moscow, Russian Federation; Urology Department of Russian University of Medicine, Moscow, Russian FederationFirst Moscow State Medical University by I.M. Sechenov (Sechenov University), Moscow, Russian FederationMoscow Urology Center, Botkin Hospital, Moscow, Russian Federation; Urology Department of Russian University of Medicine, Moscow, Russian FederationBackground and objective:: Male stress urinary incontinence (UI) remains a serious problem associated with a significant quality of life reduction. The aim of this study is to determine the safety and effectiveness of artificial urinary sphincter (AUS) and male slings (MS) for stress UI in men. Evidence acquisition:: Inclusion criteria: randomized/non-randomized trials evaluating adult men with stress UI. Exclusion criteria: repeated SUI surgery, combined conservative interventions and pharmacological treatment. The electronic databases were searched up to January 2024. The systematic review was conducted according to PICO framework and PRISMA 2020 guidelines and was registered in PROSPERO. The risk of bias was evaluated using the tools recommended by the Cochrane Society. Evidence synthesis:: Thirteen clinical trials were included in the systematic review, and 11 in the meta-analysis. There was no statistically significant difference in the improvement rate between AUS and MS (RR = 0.93, 95% CI: [0.85, 1.02], p= 0.13). MS showed statistically significant fewer infectious complication (RR = 3.26, 95% CI: [1.97, 5.39], p<0.00001), device explantation (RR = 3.29, 95% CI: [2.46, 4.41], p<0.00001), surgical revision (RR = 2.27, 95% CI: [1.60, 3.20], p<0.00001), urinary retention (RR = 0.04, 95% CI: [0.01, 0.07], p = 0.004) rates and operation time (RR = 0.93, 95% CI: [0.85, 1.02], p = 0.13) compared with AUS. Conclusion:: AUS demonstrates a comparable improvement level to MS. The operation time, infectious complication, device explantation, urinary retention, and surgical revision rates were lower in MS. More randomized and prospective studies with long-term follow-up will further increase confidence in the choice between AUS and MS for male UI treatment.http://www.sciencedirect.com/science/article/pii/S2772974524000243Male urinary incontinenceArtificial urinary sphincterSlingsPPIAUS |
| spellingShingle | Bagrat Grigoryan George Kasyan Roman Shapovalenko Dmitry Pushkar Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: Systematic review and meta-analysis Continence Reports Male urinary incontinence Artificial urinary sphincter Slings PPI AUS |
| title | Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: Systematic review and meta-analysis |
| title_full | Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: Systematic review and meta-analysis |
| title_fullStr | Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: Systematic review and meta-analysis |
| title_full_unstemmed | Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: Systematic review and meta-analysis |
| title_short | Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: Systematic review and meta-analysis |
| title_sort | safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence systematic review and meta analysis |
| topic | Male urinary incontinence Artificial urinary sphincter Slings PPI AUS |
| url | http://www.sciencedirect.com/science/article/pii/S2772974524000243 |
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