Soave A, Engel O, Rink M, Fisch M, Dahlem R
Klinik und Poliklinik für Urologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland,
Urologe A. 2014 Mar;53(3):346-53. doi: 10.1007/s00120-013-3352-9.
After synthetic sling procedures, up to 16 % of women and 45.5 % of men complain about a persistent or recurrent stress urinary incontinence (SUI). Currently, randomized studies comparing the different treatment modalities of persistent or recurrent SUI are lacking. There are data of retrospective studies investigating the efficiency of synthetic slings and the artificial urinary sphincter AMS 800® in men. Synthetic slings can be applied in patients with mild SUI and without prior radiation of the pelvic region. The AMS 800® is the treatment of choice in patients with severe SUI or previous radiation.In women with persistent and recurrent SUI, the efficiency of colposuspensions, autologous and synthetic slings as well as the AMS 800® has been investigated in retrospective studies. Due to comparable cure rates and a faster postoperative recovery, synthetic slings are now superseding colposuspensions and autologous slings. Excellent success rates after AMS 800® implantation have been described for both genders; nonetheless, postoperative complications and revisions as well as the requirement of dexterity of the patients should be taken into account. Data about the efficiency of adjustable slings, the ACT® and newer artificial urinary sphincter devices like Flow-Secure® and Zephyr® ZSI 375 in the treatment of persistent and recurrent SUI is lacking.
在进行合成吊带手术后，高达16%的女性和45.5%的男性抱怨存在持续性或复发性压力性尿失禁（SUI）。目前，缺乏比较持续性或复发性SUI不同治疗方式的随机研究。有回顾性研究数据调查了合成吊带和人工尿道括约肌AMS 800®在男性中的疗效。合成吊带可应用于轻度SUI且未接受过盆腔区域放疗的患者。AMS 800®是重度SUI或既往接受过放疗患者的首选治疗方法。在患有持续性和复发性SUI的女性中，回顾性研究已经调查了阴道悬吊术、自体和合成吊带以及AMS 800®的疗效。由于治愈率相当且术后恢复更快，合成吊带现在正在取代阴道悬吊术和自体吊带。对于男女两性，AMS 800®植入术后均有出色的成功率；尽管如此，仍应考虑术后并发症、翻修以及患者的操作灵活性要求。缺乏关于可调节吊带、ACT®以及新型人工尿道括约肌装置（如Flow-Secure®和Zephyr® ZSI 375）在治疗持续性和复发性SUI方面疗效的数据。
