Rajpurkar Atul D, Onur Rahmi, Singla Ajay
Department of Urology, Wayne State University School of Medicine, 4160 John R., Suite 1017, Detroit, MI 48201, USA.
Eur Urol. 2005 Feb;47(2):237-42; discussion 242. doi: 10.1016/j.eururo.2004.06.021.
We retrospectively evaluated the safety, efficacy and patient satisfaction following the male sling procedure for stress urinary incontinence.
Forty-six patients, with a median age of 67 years, underwent the perineal male sling procedure for stress urinary incontinence. Radical retropubic prostatectomy was the commonest etiology of SUI. The male sling was placed over the bulbar urethra, through a perineal incision and anchored with the help of bone screws inserted in the pubic rami. Efficacy and treatment satisfaction were evaluated with the help of the validated UCLA/RAND questionnaire and questions addressing treatment satisfaction. Patients were defined as "cured" if they were dry or "improved" if utilizing 1-2 pads per day (based on response to question 1 of the UCLA/RAND questionnaire. Responses to questions 4 and 5 of the UCLA/RAND were utilized to determine the impact of the procedure on urinary leakage and urinary function postoperatively. Complications if any were noted.
One patient developed infection and two developed short-lasting perineal/buttock pain. Significantly, no patient developed urethral erosion. At a mean follow-up of 24 months, 34 patients were either dry (17/46, 37%) or utilizing only 1-2 pads per day (17/46, 37%), giving a cure/improvement rate of 74%. On evaluating the response to questions 4 and 5 of the UCLA/RAND questionnaire, 72% patients stated that urinary leakage and function were a "small to no problem". Moreover, 59% patients were moderately or completely satisfied with the procedure and 11% stated they were halfway satisfied with the procedure giving an overall satisfaction of 70%. A similar percentage felt that the treatment halfway or completely met their expectations.
At a mean follow-up of 24 months, the male sling procedure appears to be effective in the management of male SUI with a success rate of 74%. Moreover, it is safe as evidenced by the absence of any major complications such as urethral erosion. Finally, it is associated with a 70% patient satisfaction.
我们回顾性评估了男性吊带手术治疗压力性尿失禁后的安全性、有效性及患者满意度。
46例患者接受了会阴男性吊带手术治疗压力性尿失禁，中位年龄67岁。根治性耻骨后前列腺切除术是压力性尿失禁最常见的病因。男性吊带经会阴切口置于球部尿道上方，并借助插入耻骨支的骨螺钉固定。借助经过验证的加州大学洛杉矶分校/兰德公司问卷及有关治疗满意度的问题评估疗效和治疗满意度。如果患者干爽，则定义为“治愈”；如果每天使用1 - 2片尿垫，则定义为“改善”（基于对加州大学洛杉矶分校/兰德公司问卷第1题的回答）。使用加州大学洛杉矶分校/兰德公司问卷第4题和第5题的回答来确定该手术对术后尿失禁和排尿功能的影响。记录所有并发症。
1例患者发生感染，2例出现短暂的会阴/臀部疼痛。值得注意的是，无患者发生尿道侵蚀。平均随访24个月时，34例患者干爽（17/46，37%）或每天仅使用1 - 2片尿垫（17/46，37%），治愈/改善率为74%。在评估对加州大学洛杉矶分校/兰德公司问卷第4题和第5题的回答时，72%的患者表示尿失禁和排尿功能“问题很小或没有问题”。此外，59%的患者对该手术中度或完全满意，11%的患者表示对该手术“半满意”，总体满意度为70%。类似比例的患者认为治疗基本或完全达到了他们的期望。
平均随访24个月时，男性吊带手术治疗男性压力性尿失禁似乎有效，成功率为74%。此外，由于未出现诸如尿道侵蚀等任何重大并发症，该手术是安全的。最后，患者满意度为70%。
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