Comiter Craig V
Section of Urology, Department of Surgery, University of Arizona, Arizona 85724, USA.
Neurourol Urodyn. 2005;24(7):648-53. doi: 10.1002/nau.20166.
In men with stress urinary incontinence (SUI) due to sphincteric incompetence, surgical options include periurethral injection of bulking agents, implantation of an artificial urinary sphincter (AUS), and sling surgery. Short-term results of the male sling have generally been favorable. We report the intermediate-term results of the bone-anchored male perineal sling with a median of 4 years and minimum of 2 years follow-up.
From March 2000 to April 2003, 48 patients (average age = 68 years) underwent male sling surgery. Patients were evaluated pre-operatively and post-operatively via history, physical examination, pad score, and administration of the incontinence section of the UCLA/RAND prostate cancer index (PCI).
Pre-operatively all patients rated their incontinence as severe, and used >or=3 pads daily. Median follow-up was 48 months (range = 24-60). Average pad usage decreased from 4.6 +/- 2.1 pads per day to 1.0 +/- 1.7 pads per day (P < 0.01). Median UCLA PCI incontinence score increased from 63-343 (P < 0.01). Overall, 31/48 patient (65%) were cured of their leakage (no problem, no pads), 7/48 (15%) were much improved (small problem, 1 pad), 3/48 (6%) were mildly improved (moderate problem, 2 pads daily), and 7/48 (15%) failed (big problem, >or=3 pads).
Intermediate-term results for the male sling demonstrate a success rate comparable to that of the AUS (80% <or= 1 pad daily). This technique has established a very low morbidity, and is a reliable alternative to AUS surgery for the treatment of male SUI.
对于因括约肌功能不全导致压力性尿失禁（SUI）的男性患者，手术选择包括尿道周围注射填充剂、植入人工尿道括约肌（AUS）和吊带手术。男性吊带手术的短期效果总体良好。我们报告了骨锚定男性会阴吊带的中期结果，中位随访时间为4年，最短随访时间为2年。
2000年3月至2003年4月，48例患者（平均年龄 = 68岁）接受了男性吊带手术。通过病史、体格检查、尿垫评分以及UCLA/RAND前列腺癌指数（PCI）失禁部分的评估对患者进行术前和术后评估。
术前所有患者均将其尿失禁评为重度，且每天使用≥3个尿垫。中位随访时间为48个月（范围 = 24 - 60个月）。平均尿垫使用量从每天4.6±2.1个减少至每天1.0±1.7个（P < 0.01）。UCLA PCI失禁评分中位数从63提高到343（P < 0.01）。总体而言，48例患者中有31例（65%）漏尿治愈（无问题，不用尿垫），7例（15%）有显著改善（小问题，使用1个尿垫），3例（6%）有轻度改善（中度问题，每天使用2个尿垫），7例（15%）手术失败（大问题，使用≥3个尿垫）。
男性吊带手术的中期结果显示成功率与AUS相当（每天使用≤1个尿垫的比例≥80%）。该技术发病率极低，是治疗男性SUI的AUS手术的可靠替代方法。
