Ullrich Nathan F E, Comiter Craig V
University of Arizona Health Sciences Center and the Southern Arizona Veterans Affairs Health Care System, Tucson, Arizona, USA.
J Urol. 2004 Jul;172(1):207-9. doi: 10.1097/01.ju.0000128652.99627.14.
Stress urinary incontinence after prostate surgery can be a bothersome problem, adversely affecting quality of life. We performed a prospective study of the male perineal sling for the treatment of stress urinary incontinence with a minimum 1-year followup.
A total of 36 patients (average age 67 years old) underwent male sling surgery. Patients underwent preoperative and postoperative evaluation for bother due to urinary incontinence using the UCLA Prostate Cancer Index urinary function section as well as pad score.
Median followup was 25 months (range 12 to 42). After surgery 24 (67%) patients were pad-free, 5 (14%) used 1 pad, 4 (11%) used 2 pads and 3 (8%) continued to use 3 or more pads daily. Overall, mean pad use +/- SD decreased from 4.6 +/- 2.5 to 0.64 +/- 1.0 pads daily (p <0.001). A total of 30 (83%) patients reported a small to no bother from urine leakage after surgery, 3 (8%) considered leakage a moderate problem, while 3 (8%) continued to consider it a big problem. The median UCLA Prostate Cancer Index urinary function score was improved from 33 before surgery to 330 after surgery (p <0.001). There were no instances of erosion, infection or prolonged retention.
Medium term results for the male sling demonstrate a success rate comparable to that of the artificial urinary sphincter (67% pad-free rate and 92% improvement). This technique has established a low morbidity and has not been associated with any significant complications. Longer followup will ultimately establish whether this technique represents a viable long-term alternative to artificial urinary sphincter for the treatment of bothersome stress urinary incontinence in men.
前列腺手术后压力性尿失禁可能是一个令人困扰的问题，会对生活质量产生不利影响。我们进行了一项关于男性会阴吊带治疗压力性尿失禁的前瞻性研究，随访时间至少为1年。
共有36例患者（平均年龄67岁）接受了男性吊带手术。患者在术前和术后使用加州大学洛杉矶分校前列腺癌指数尿功能部分以及尿垫评分对尿失禁引起的困扰进行评估。
中位随访时间为25个月（范围12至42个月）。术后，24例（67%）患者无需使用尿垫，5例（14%）使用1片尿垫，4例（11%）使用2片尿垫，3例（8%）继续每天使用3片或更多尿垫。总体而言，平均每日尿垫使用量±标准差从4.6±2.5降至0.64±1.0片（p<0.001）。共有30例（83%）患者报告术后尿漏带来的困扰较小或无困扰，3例（8%）认为尿漏是一个中度问题，而3例（8%）继续认为这是一个严重问题。加州大学洛杉矶分校前列腺癌指数尿功能评分中位数从术前的33提高到术后的330（p<0.001）。没有发生侵蚀、感染或长期尿潴留的情况。
男性吊带的中期结果显示成功率与人工尿道括约肌相当（无尿垫率67%，改善率92%）。该技术的发病率较低，且未出现任何严重并发症。更长时间的随访最终将确定该技术是否是治疗男性困扰性压力性尿失禁的人工尿道括约肌的可行长期替代方法。
