Moreno Sierra Jesús, Victor Romano Salomón, Galante Romo Isabel, Barrera Ortega Jerónimo, Salinas Casado Jesús, Silmi Moyano Angel
Servicio de Urologia, Hospital Clínico San Carlos, Universidad Complutense, Madrid.
Arch Esp Urol. 2006 Jul-Aug;59(6):607-13. doi: 10.4321/s0004-06142006000600007.
Male stress urinary incontinence is usually a consequence or sequel of a prostatic surgical procedure (radical prostatectomy, surgery for BPH or bladder neck sclerosis: adenomectomy, conventional and/or bipolar transurethral resection, laser...). This kind of surgery may have undesirable effects on the quality of life and patients' expectations, although we should bear in mind that the primary objective in patients with prostate adenocarcinoma is to cure cancer and for patients with obstructive lower urinary tract symptoms to improve their voiding quality Over the last decade, surgical procedures to compress the bulbar urethra with slings have been employed successfully in the treatment of male stress urinary incontinence, being considered highly effective in the treatment of post-prostatectomy incontinence in the long-term by groups with large experience. To describe the elements of the Argus system, its indications, and the surgical technique for its implant and adjustment, modified from Schäeffer and carried out by Victor Romano.
Argus system: The sling has three components: radiopaque cushioned system with silicone foam, 42 mm x 26 mm x 9 mm, which is waterproof to body fluids; two silicone columns formed by multiple conical elements, which allow system readjustment; and two radiopaque silicone washers (15 mm diameter and 2.9 mm width) which enable proper fixation and readjustment (Figure 1). Once the system is open, it is recommended to place the sling within antibiotic solution until implantation.
男性压力性尿失禁通常是前列腺手术（根治性前列腺切除术、良性前列腺增生或膀胱颈硬化症手术：腺瘤切除术、传统和/或双极经尿道切除术、激光……）的后果或后遗症。这类手术可能会对生活质量和患者期望产生不良影响，不过我们应牢记，前列腺腺癌患者的主要目标是治愈癌症，而有下尿路梗阻症状的患者则是改善排尿质量。在过去十年中，使用吊带压迫球部尿道的手术已成功用于治疗男性压力性尿失禁，经验丰富的团队认为其对前列腺切除术后尿失禁的长期治疗非常有效。描述阿格斯系统的组成部分、适应证及其植入和调整的手术技术，该技术由维克托·罗曼诺根据舍费尔的方法进行改良。
阿格斯系统：吊带由三个部分组成：带有硅酮泡沫的不透射线缓冲系统，42毫米×26毫米×9毫米，对体液防水；由多个锥形元件组成的两个硅酮柱，可进行系统重新调整；以及两个不透射线的硅酮垫圈（直径15毫米，宽度2.9毫米），用于正确固定和重新调整（图1）。系统打开后，建议将吊带置于抗生素溶液中直至植入。
