García-Montes Fernando
Unidad de Suelo Pélvico, Hospital Universitario Son Dureta, 07012 Palma de Mallorca, España.
Arch Esp Urol. 2009 Dec;62(10):845-50. doi: 10.4321/s0004-06142009001000009.
To diffuse the concept and implantation surgical technique of a new prosthesis for the treatment of stress urinary incontinence, the Flow Secure artificial urinary sphincter.
The prosthesis is a single silicone piece filled with saline solution which has the following parts: (1) Pressure regulation reservoir, (2) assistance reservoir for stress situations, (3) control pump with self-sealant port and (4) a cuff. One of the main characteristics is the self-sealant port enables pressure adjustment depending of the clinical needs of the patient as many times as necessary.
The surgical technique is simple and the level of continence achieved excellent. The only complication inherent to the Flow Secure design is perforation of the cuff during the act of pressurization, but it has been corrected by designing a new control pump which can not be punctured. Self limited scrotal edema/hematoma are frequent; they can be avoided minimizing the time of trocar use. The remainder complications are common with the AMS 800 and other implantable prosthesis.
Despite midterm good results, we need to wait for a greater number of patients with the Flow Secure sphincter and longer follow up to determine the definitive role of this prosthesis for the treatment of urinary incontinence.
推广一种用于治疗压力性尿失禁的新型假体——Flow Secure人工尿道括约肌的概念及植入手术技术。
该假体是一个填充有盐溶液的单一硅胶部件，具有以下部分：（1）压力调节储液器，（2）应激情况下的辅助储液器，（3）带有自密封端口的控制泵，以及（4）一个袖带。其主要特点之一是自密封端口能够根据患者的临床需求，在必要时多次进行压力调节。
手术技术简单，控尿水平极佳。Flow Secure设计固有的唯一并发症是在加压过程中袖带穿孔，但通过设计一种不会被刺破的新型控制泵已得到纠正。阴囊自限性水肿/血肿很常见；可以通过尽量缩短套管针使用时间来避免。其余并发症与AMS 800及其他可植入假体常见的并发症相同。
尽管中期效果良好，但我们需要等待更多使用Flow Secure括约肌的患者以及更长时间的随访，以确定该假体在治疗尿失禁方面的确切作用。
