De Giovanni Luciano, Stefanucci Marco, Menchinelli Paolo
Divisione di Chirurgia Urologica, Università Cattolica del Sacro Cuore, Complesso Integrato Columbus, Roma, Italy.
Arch Ital Urol Androl. 2012 Sep;84(3):155-7.
To report clinical experience and economical aspects concerning the use of a peri-urethral constrictor for the treatment of male urinary incontinence after surgery.
Twelve patients were treated with the periurethral constrictor Vedise. They previously underwent prostate surgery and reported persistent urinary incontinence, subjectively judged as disabling. In all the cases at least 18 months had elapsed from the date of the previous operation to the date of observation.
No complications were observed during the application of the device, nor during the first postoperative period; the patients were discharged on the first postoperative day. In two patients the failure of the device was observed with immediate reappearance of urinary losses due to damage of the balloon during the activation procedure. In these cases it was necessary to replace the balloon with subsequent reactivation of the device. In a third patient the detachment of the tubing connecting the cup with the balloon was reported and finally in a fourth patient a tight recurrent urethral stricture requested the removal of the device. The remaining patients, followed up for about 12 months after the implantation, considered the application of the device as a positive experience, would recommend it to other patients and would repeat the implantation, if required.
The relevance of the preliminary selection of the patients and the need for meticulous attention during installation an activation of the device is stressed and possible modification of the device are suggested to increase both effectiveness and ease of use.
报告使用尿道周围收缩器治疗男性术后尿失禁的临床经验和经济方面的情况。
12例患者接受了尿道周围收缩器Vedise治疗。他们之前接受过前列腺手术，且存在持续性尿失禁，主观上认为这种情况导致了生活不便。在所有病例中，从上一次手术日期到观察日期至少过去了18个月。
在装置应用过程中以及术后第一个阶段均未观察到并发症；患者在术后第一天出院。2例患者出现装置故障，在启动过程中球囊受损导致尿液立即重新漏出。在这些病例中，有必要更换球囊并随后重新启动装置。第3例患者报告连接杯体与球囊的管道脱落，最后第4例患者因严重复发性尿道狭窄而需要取出装置。其余患者在植入后随访约12个月，认为装置的应用是一次积极的体验，会向其他患者推荐，如果需要会再次植入。
强调了患者初步选择的重要性以及在装置安装和启动过程中需要细致关注，并建议对装置进行可能的改进以提高有效性和易用性。
