Original Title: Esfínter urinario artificial en incontinencia urinaria post prostatectomía

Authors' recommendations: Moderate-quality evidence shows that artificial urinary sphincter, when compared with urethral sling, probably yields a significant net benefit in patients with moderate to severe urinary incontinence post-prostatectomy since it has advantages in terms of less pad weight and rates of use. Additionally, there are no significant differences between both devices as regards complications and effects on quality of life. In relation to the clinical practice guidelines surveyed, most of them indicate that male slings are usually recommended in cases of mild to moderate urinary incontinence, while artificial urinary sphincters are preferred in moderate to severe urinary incontinence; however, the accurate definition of severity remains unclear. The choice between these two procedures should be based on the characteristics of each individual patient, such as personal preferences, incontinence severity and the surgeon expertise, to ensure the best clinical outcome and patient satisfaction. In Latin America, coverage in cases of severe urinary incontinence post-prostatectomy has been only identified in Brazil, where the National Agency of Supplementary Health ensures coverage 12 months post-procedure. In high-income countries such as Australia, the United States and the United Kingdom, coverage is also provided. Aetna, an American health insurance company, considers that artificial urinary sphincter is medically necessary to treat cases where six months or longer have elapsed post-prostatectomy and no improvement has been observed in the severity of urine incontinence despite behavioral and pharmacological treatments. No economic evaluation of the artificial urinary sphincter has been identified in Argentina. However, a study conducted in United Kingdom compared the synthetic sling with the artificial urinary sphincter for one year. No significant differences were found in terms of cost-effectiveness. Also, one study conducted in Canada assessed both technologies for a period of 5-10 years, and it concluded that the artificial urinary sphincter was more cost-effective.

Project Status: Completed

Year Published: 2024

URL for published report: https://ets.iecs.org.ar/publication/2204

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: <p>Institute for Clinical Effectiveness and Health Policy (IECS)</p>