Department of Urology, Medical University of Graz, Graz, Austria.
J Urol. 2011 Aug;186(2):604-9. doi: 10.1016/j.juro.2011.03.131.
In recent years various sling systems have been proposed as a successful treatment option for male stress urinary incontinence. Reports about complication rates and failures are still scarce.
We systematically reevaluated 29 male patients who received an Argus® suburethral sling for stress urinary incontinence between October 2006 and July 2007.
Overall 24 patients (83%) experienced a total of 37 complications at a median followup of 35 months (range 29 to 45), including 10 (35%) in acute urinary retention. The sling was removed in 10 patients (35%) due to urethral erosion (3), infection (2), system dislocation (2), urinary retention (2) and persistent pain (1). Eight men (27%) complained of significant perineal pain, necessitating continuous oral analgesics. In 1 patient ureteral reimplantation was done due to ureteral erosion from a dislocated sling. At followup only 5 men (17%) remained dry while 21 (72%) were dissatisfied with the clinical outcome. No available clinical variables were statistically significantly associated with any grade or high grade complications even on univariate analysis.
In our study cohort the Argus suburethral sling was associated with serious mechanical and infectious complications, and sparse functional results with negative impact on patient quality of life. Based on the results of this study significant changes are warranted in the sling system and in the implantation technique.
近年来，各种吊带系统已被提出作为男性压力性尿失禁的成功治疗选择。关于并发症发生率和失败的报道仍然很少。
我们系统地重新评估了 29 名 2006 年 10 月至 2007 年 7 月间因压力性尿失禁接受 Argus®尿道下吊带治疗的男性患者。
总体而言，24 名患者（83%）在中位随访 35 个月（29 至 45 个月）时共发生了 37 次并发症，包括 10 例（35%）急性尿潴留。由于尿道侵蚀（3 例）、感染（2 例）、系统脱位（2 例）、尿潴留（2 例）和持续疼痛（1 例），10 名患者（35%）取出吊带。8 名男性（27%）抱怨严重会阴部疼痛，需要持续口服止痛药。1 例患者因脱位吊带导致输尿管侵蚀而行输尿管再植入术。随访时，仅有 5 名男性（17%）保持干燥，21 名男性（72%）对临床结果不满意。即使在单变量分析中，也没有任何可用的临床变量与任何等级或高等级并发症有统计学显著相关性。
在我们的研究队列中，Argus 尿道下吊带与严重的机械和感染并发症相关，功能结果稀疏，并对患者的生活质量产生负面影响。基于这项研究的结果，吊带系统和植入技术需要进行重大改变。
