Noll F, Schreiter F
Urologische Klinik, Universität Witten-Herdecke, Verbandskrankenhaus Schwelm.
Urologe A. 1991 Sep;30(5):294-8.
From 1983 to May 1991, the artificial sphincter AS800 has been applied in 106 female patients for the treatment of complicated cases of urinary incontinence. Of these, 80 remained in continuous follow-up and have now been followed up for at least 1 year, with a mean of 3.8 years. In 40 of our female patients the urethra was afunctional secondary to failure of previous anti-stress-incontinence procedures. Neurogenic incontinence with sphincteric involvement affected 30, while 10 of the patients had congenital sphincter anomalies or traumatic sphincter weakness. Following implantation of the artificial sphincter, 86.3% of these patients are completely continent and do not need a pad. With regard to emptying, 81.3% are able to empty their bladder without residual urine after opening the sphincter, and 8 have to perform clean intermittent catheterization (CIC) once or twice daily in addition. A further 7 void exclusively by CIC. As preparation for implantation of the AS800 sphincter, 24 additional procedures were performed, including 5 antireflux operations and 6 bladder-flap procedures. In 38 of 80 patients a total of 62 revisions were performed. Infection and erosion were the most common reasons for revision, accounting for 48.2% of all revisions. The next most common reason was tissue atrophy underneath the cuff. However, 25% of the revisions were due to device failures, most often cuff leakage.
1983年至1991年5月，人工括约肌AS800已应用于106例女性患者，用于治疗复杂的尿失禁病例。其中，80例患者持续接受随访，目前随访时间至少为1年，平均随访时间为3.8年。在我们的40例女性患者中，尿道因先前抗压力性尿失禁手术失败而失去功能。伴有括约肌受累的神经源性尿失禁患者有30例，而10例患者有先天性括约肌异常或创伤性括约肌无力。植入人工括约肌后，这些患者中有86.3%完全控尿，无需使用尿垫。在排尿方面，81.3%的患者在打开括约肌后能够排空膀胱且无残余尿，另外8例患者每天还需进行一到两次清洁间歇性导尿（CIC）。另有7例患者完全依靠CIC排尿。作为植入AS800括约肌的准备工作，还进行了24项额外手术，包括5例抗反流手术和6例膀胱瓣手术。80例患者中有38例共进行了62次翻修手术。感染和侵蚀是翻修手术最常见的原因，占所有翻修手术的48.2%。其次最常见的原因是袖带下方的组织萎缩。然而，25%的翻修手术是由于器械故障，最常见的是袖带泄漏。
