Basiri Abbas, Kilani Hossein
Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Urol J. 2013 Winter;10(1):802-6.
To present our experience of using an adjustable male sling, Argus® (Promedone SA; Cordoba, Argentina), in patients with stress urinary incontinence (SUI), and report its success, extension of indications, and management of complications.
We retrospectively evaluated Argus implantation results in 17 patients, including 15 post prostatectomy incontinence, one exstrophy-epispadias, and one neurogenic bladder patient. Of 17 patients, 12 had severe (more than 5 pads daily) and 5 had moderate SUI (2 to 5 pads daily). Seven patients had history of previous surgeries. Patients were evaluated pre-operatively with urodynamic study and cystoscopy.
After median follow-up of 11.8 months (range, 3 to 22 months), 9 patients were continent, 7 had mild SUI (1 pad daily), and one had the device removed due to perineal and bladder symptoms. Argus adjustment was done in 10 out of 17 patients; 8 tightening and 2 loosening. In a totally incontinent exstrophy-epispadias patient with a history of multiple bladder surgeries, continence was achieved after device readjustment. In a patient with neurogenic bladder with a history of cystoplasty, severe SUI changed into a moderate sporadic SUI. In 2 patients, prosthesis infection occurred, which was managed with antibiotics without the need for Argus explantation.
Argus is a simple and good device to control incontinence in men. It may also be used in exstrophy-epispadias patient who is not a candidate for urinary sphincter implantation. Infection complication may be managed conservatively. To the best of our knowledge, this is the first report of successful Argus implantation in exstrophy-epispadias patient.
介绍我们使用可调节男性吊带Argus®（Promedone SA；阿根廷科尔多瓦）治疗压力性尿失禁（SUI）患者的经验，并报告其成功率、适应证扩展及并发症处理情况。
我们回顾性评估了17例患者的Argus植入结果，其中包括15例前列腺切除术后尿失禁患者、1例膀胱外翻-尿道上裂患者和1例神经源性膀胱患者。17例患者中，12例为重度（每日使用超过5片尿垫）SUI，5例为中度SUI（每日使用2至5片尿垫）。7例患者有既往手术史。患者术前接受尿动力学检查和膀胱镜检查。
中位随访11.8个月（范围3至22个月）后，9例患者实现控尿，7例有轻度SUI（每日使用1片尿垫），1例因会阴部和膀胱症状取出装置。17例患者中有10例进行了Argus调整；8例收紧，2例放松。在1例有多次膀胱手术史的完全性尿失禁膀胱外翻-尿道上裂患者中，装置调整后实现了控尿。在1例有膀胱成形术史的神经源性膀胱患者中，重度SUI转变为中度偶发性SUI。2例患者发生假体感染，经抗生素治疗，无需取出Argus。
Argus是一种控制男性尿失禁的简单且良好的装置。它也可用于不适合植入尿道括约肌的膀胱外翻-尿道上裂患者。感染并发症可保守处理。据我们所知，这是首次关于在膀胱外翻-尿道上裂患者中成功植入Argus的报告。
