The treatment of choice for patients who have iatrogenic stress urinary incontinence (SUI) is implantation of an artificial urinary sphincter. The purpose of this video is to present the technique of implantation of the artificial urinary sphincter ZSI 375 (Zephyr Surgical Implants, Geneva, Switzerland) using our own modification.
The video presents the procedure of implantation of the artificial urinary sphincter ZSI 375. The surgical procedure was performed under general or regional anaesthesia and a 16 F Foley catheter was inserted for guidance. Patients were placed in the lithotomy position and a traditional surgical technique was used consisting of a perineal incision for cuff placement and inguinal incision for pump unit scrotal placement in all the cases. Between July 2013 and March 2019, 74 patients underwent the artificial urinary sphincter ZSI 375 implantation. The average length of operation was 1 hour and 10 min (45 min – 2 hours 30 min). No patients experienced any early Clavien-Dindo grade II–V complications. There were no cases of infections caused by the procedure. During the medium- term follow-up, we noticed 3 mechanic failures of the artificial sphincter and 10 episodes of erosion. The artificial urinary sphincter is well tolerated, effective and recommended for male SUI treatment by urological guidelines.
The procedure of implantation of the artificial urinary sphincter ZSI 375 is allegedly safe, short and effective. The good results of implantation depend on patient's characteristics. A larger research group is needed to confirm these results and define possible complications.