前瞻性评估男性前列腺切除术后压力性尿失禁的功能吊带悬吊术：1 年后的结果。
Prospective evaluation of the functional sling suspension for male postprostatectomy stress urinary incontinence: results after 1 year.
机构信息
Urological Department, Ludwig-Maximilian-University, Munich, Germany.
出版信息
Eur Urol. 2009 Dec;56(6):928-33. doi: 10.1016/j.eururo.2009.07.028. Epub 2009 Jul 29.
BACKGROUND
Although surgical techniques for radical prostatectomy (RP) have been refined significantly, a significant number of patients still suffer from persisting postprostatectomy stress urinary incontinence (SUI). In recent years, various minimally invasive sling systems have been investigated as treatment options for such incontinence.
OBJECTIVE
The aim of the study was the prospective evaluation of the efficacy of the retrourethral transobturator sling for the functional treatment of male SUI after RP.
DESIGN, SETTING, AND PARTICIPANTS: The study documents a single-centre prospective evaluation of the outcome of 124 patients with mild to severe SUI following RP in whom an AdVance sling was implanted between February 2006 and September 2008.
MEASUREMENTS
All patients were comprehensively evaluated preoperatively and after 6 mo and 1 yr regarding daily pad use, 1-h and 24-h pad tests, residual urine, uroflowmetry, Incontinence Quality of Life Scale (I-QOL) score, and Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) score. Data were collected prospectively.
RESULTS AND LIMITATIONS
After 6 mo, a cure rate (no pads or one dry security pad) of 55.8%, an improved rate (one to two pads or pad reduction≥50%) of 27.4%, and a failure rate of 16.8% were observed. After 1 yr, the cure rate was 51.4%, the improved rate was 25.7%, and the failure rate was 22.9%. Daily pad use and pad weight decreased significantly postoperatively. No significant changes were seen in residual urine and flow rate. Quality-of-life scores improved significantly. Postoperative acute urinary retention was seen in 12.9% of patients. One patient had a local wound infection that was cured with antibiotics. One patient had the sling removed due to misplacement.
CONCLUSIONS
The retrourethral transobturator sling is an effective and attractive treatment option for male SUI resulting from RP after 1 yr of implantation.
背景
尽管根治性前列腺切除术 (RP) 的手术技术已经得到了显著改进，但仍有相当数量的患者持续存在前列腺切除术后压力性尿失禁 (SUI)。近年来，各种微创吊带系统已被研究作为治疗此类尿失禁的选择。
目的
本研究旨在前瞻性评估经尿道后尿道吊带系统治疗 RP 后男性 SUI 的疗效。
设计、地点和参与者：该研究记录了 2006 年 2 月至 2008 年 9 月期间，在 124 例轻度至重度 RP 后 SUI 患者中植入 AdVance 吊带的单中心前瞻性评估结果。
测量
所有患者在术前和术后 6 个月和 1 年均进行了全面评估，包括日常垫使用情况、1 小时和 24 小时垫试验、残余尿量、尿流率、尿失禁生活质量量表 (I-QOL) 评分和尿失禁问卷-尿失禁简短量表 (ICIQ-UI SF) 评分。数据是前瞻性收集的。
结果和局限性
术后 6 个月时，治愈率（无垫或一个干燥安全垫）为 55.8%，改善率（一个到两个垫或垫减少≥50%）为 27.4%，失败率为 16.8%。术后 1 年时，治愈率为 51.4%，改善率为 25.7%，失败率为 22.9%。术后，日常垫使用和垫重量明显减少，残余尿量和流量率无明显变化。生活质量评分显著提高。术后急性尿潴留发生率为 12.9%。1 例患者出现局部伤口感染，经抗生素治愈。1 例患者因位置不当而去除吊带。
结论
经尿道后尿道吊带是 RP 后 1 年男性 SUI 的有效且有吸引力的治疗选择。
Zotero 插件