O'Connor R Corey, Gerber Glenn S, Avila Desiderio, Chen Andrew A, Bales Gregory T
Section of Urology, Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois 60637, USA.
Urology. 2003 Oct;62(4):723-6. doi: 10.1016/s0090-4295(03)00572-7.
To assess the effectiveness and complications associated with single and double-cuff artificial urinary sphincter (AUS) implantation for postprostatectomy stress urinary incontinence.
A retrospective study of 56 men with postprostatectomy stress urinary incontinence who underwent either single (28 patients) or double (28 patients) cuff AUS placement was performed. Patients in each cohort were matched on the basis of preoperative pad use, risk factors for complications, and age. Patient selection was blinded relative to outcome. Continence, quality of life, and complications were assessed using the Incontinence Impact Questionnaire Short Form (IIQ-7), postoperative pad use, and chart review.
The mean age was 67 years for each group. Daily pad use decreased from 7.7 to 1.1 in patients treated with a single-cuff AUS and from 7.8 to 0.7 in patients with a double-cuff AUS (P = 0.25). Complete continence (0 pads daily) was reported in 3 (11%) of 28 men with single-cuff and 12 (43%) of 28 men with double-cuff sphincters (P = 0.008). The IIQ-7 scores improved from 14.8 to 3.1 after single-cuff placement and from 16.3 to 2.5 after double-cuff placement (P = 0.03). With an average follow-up of 41.3 and 21.2 months for the single and double-cuff cohorts, respectively, five complications were reported in the single-cuff recipients and four in the double-cuff patients.
A significantly greater rate of complete continence and improvement in the IIQ-7 were seen in men with double-cuff AUS compared with single-cuff devices. Additional study is needed to confirm the relative advantages of double-cuff insertion.
评估单环和双环人工尿道括约肌（AUS）植入术治疗前列腺切除术后压力性尿失禁的有效性及并发症。
对56例前列腺切除术后压力性尿失禁患者进行回顾性研究，其中28例患者接受单环AUS植入，28例患者接受双环AUS植入。每组患者根据术前使用尿垫情况、并发症危险因素和年龄进行匹配。患者选择对结果设盲。采用尿失禁影响问卷简表（IIQ - 7）、术后尿垫使用情况及病历审查评估尿失禁控制情况、生活质量和并发症。
每组的平均年龄均为67岁。单环AUS治疗的患者每日尿垫使用量从7.7片降至1.1片，双环AUS治疗的患者从7.8片降至0.7片（P = 0.25）。28名单环AUS男性患者中有3例（11%）报告完全控尿（每日0片尿垫），28名双环括约肌男性患者中有12例（43%）（P = 0.008）。单环植入后IIQ - 7评分从14.8提高到3.1，双环植入后从16.3提高到2.5（P = 0.03）。单环和双环队列的平均随访时间分别为41.3个月和21.2个月，单环植入患者报告有5例并发症，双环植入患者有4例。
与单环装置相比，双环AUS男性患者的完全控尿率显著更高，IIQ - 7评分改善更明显。需要进一步研究以证实双环植入的相对优势。
