Kryger J V, Leverson G, González R
University of Wisconsin Children's Hospital, Madison, Wisconsin, USA.
J Urol. 2001 Jun;165(6 Pt 2):2377-9. doi: 10.1016/S0022-5347(05)66208-8.
The long-term success and efficacy of the artificial urinary sphincter for the management of neurogenic incontinence have been well documented. We evaluated if long-term results were affected by patient age at the time of sphincter placement.
A retrospective review of the medical records of patients who underwent artificial urinary sphincter placement and had minimum of 10 years of followup was conducted. All patients with an intact sphincter were interviewed to assess current results. Patients were stratified into groups 1 and 2 if the sphincter was implanted before or after age 11 years, respectively, and the results were compared statistically.
An artificial urinary sphincter was placed in 45 children at Children's Hospital of Michigan between October 1978 and August 1986, and medical records and followup were available for 32. Mean followup was 15.4 years. Of the 21 group 1 patients 12 (57%) have an intact sphincter after 26 revisions, and all are dry and 9 (75%) require intermittent catheterization. Of the 11 group 2 patients 7 (64%) have an intact sphincter, and 6 (86%) are dry, 3 (43%) perform intermittent catheterization and 6 required 8 revisions. There was no statistically significant difference in the number of artificial urinary sphincter removals, continence, revision rate, bladder augmentations, complications or upper tract changes.
The artificial urinary sphincter is a successful and durable option for the surgical management of neurogenic incontinence. The long-term results appear independent of patient age at the time of sphincter placement.
人工尿道括约肌用于治疗神经源性尿失禁的长期成功率和疗效已有充分记录。我们评估了括约肌植入时患者年龄是否会影响长期结果。
对接受人工尿道括约肌植入且至少随访10年的患者病历进行回顾性研究。对所有括约肌完整的患者进行访谈以评估当前结果。根据括约肌植入时患者年龄是否在11岁之前或之后，将患者分别分为1组和2组，并对结果进行统计学比较。
1978年10月至1986年8月期间，密歇根儿童医院为45名儿童植入了人工尿道括约肌，其中32名患者有病历记录和随访资料。平均随访时间为15.4年。1组的21名患者中，12名（57%）在26次翻修后括约肌完整，均无尿失禁，9名（75%）需要间歇性导尿。2组的11名患者中，7名（64%）括约肌完整，6名（86%）无尿失禁，3名（43%）进行间歇性导尿，6名需要8次翻修。人工尿道括约肌移除次数、控尿情况、翻修率、膀胱扩大术、并发症或上尿路改变方面无统计学显著差异。
人工尿道括约肌是治疗神经源性尿失禁手术的一种成功且持久的选择。长期结果似乎与括约肌植入时的患者年龄无关。
