James Buchanan Brady Urological Institute, Johns Hopkins Medical Institution, Baltimore, Maryland 21224, USA.
Neurourol Urodyn. 2013 Jan;32(1):63-5. doi: 10.1002/nau.22263. Epub 2012 Jun 12.
The aim of the study is to evaluate the causes for artificial urinary sphincter (AUS) failure in a contemporary series, and to detect modifiable risk factors for device-related complications. The aim is to also report outcome after AUS revision.
We retrospectively reviewed the medical records of consecutive patients who underwent AUS revision at a tertiary care institution by a single surgeon from 2006 to 2011. There were 53 AUS revisions performed on 34 patients at a median age of 69 years.
Urethral atrophy was the most common indication for revision. Fourteen patients (41%) underwent more than one revision. Seven patients had urethral catheterization in the setting of an active AUS while admitted to a non-urologic service; these patients all developed cuff erosion. Fifty-four percent of urethral erosions were associated with such traumatic catheterizations. After revision, 80% of patients with an AUS in place were using one or no pad daily at mean follow up of 27 months.
Urethral atrophy remains the most common reason for AUS revision. More than half of all urethral erosions are secondary to urethral catheterization in the setting of an active sphincter, suggesting that some of the risk of device-related morbidity may be modifiable.
本研究旨在评估当代一系列人工尿道括约肌（AUS）故障的原因，并发现与设备相关并发症的可修正风险因素。本研究的目的还在于报告 AUS 修复后的结果。
我们回顾性分析了 2006 年至 2011 年间，一位外科医生在一家三级医疗机构对连续患者进行 AUS 修复的病历。34 名患者接受了 53 次 AUS 修复，中位年龄为 69 岁。
尿道萎缩是最常见的修复指征。14 名患者（41%）接受了不止一次修复。7 名患者在非泌尿科病房因 AUS 处于活动状态而行尿道置管术，这些患者均发生袖套侵蚀。54%的尿道侵蚀与这种创伤性置管有关。修复后，80%的 AUS 在位患者在平均 27 个月的随访中每天使用一个或不使用护垫。
尿道萎缩仍然是 AUS 修复最常见的原因。超过一半的尿道侵蚀是由于括约肌活动时的尿道置管引起的，这表明一些与设备相关的发病率的风险因素可能是可以修正的。
