Biardeau X, Aharony S, Campeau L, Corcos J
Department of Urology, Jewish General Hospital, McGill University, Montreal, Québec, Canada.
Neurourol Urodyn. 2016 Apr;35 Suppl 2:S8-24. doi: 10.1002/nau.22989.
The AMS800™ device, by far the most frequently implanted artificial urinary sphincter (AUS) worldwide, is considered to be the "gold-standard" when male incontinence surgical treatment is contemplated. Despite 40 years of experience, it is still a specialized procedure with a number of challenges. Here, we present the recommendations issued from the AUS Consensus Group, regarding indications, management, and follow-up AMS800™ implantation or revision.
Under ICS auspices, an expert panel met on July 10, 2015 in Chicago, IL, USA in an attempt to reach a consensus on diverse issues related to the AMS800™ device. Participants were selected by the two co-chairs on the basis of their practice in a University hospital and their experience: number of implanted AUSs according to AMS (American Medical System Holdings Inc., Minnetonka, MN) records and/or major published articles. Topics listed were the result of a pre-meeting email brainstorming by all participants. The co-chairs distributed topics randomly to all participants, who then had to propose a statement on each topic for approval by the conference after a short evidence-based presentation, when possible.
A total of 25 urologists were invited to participate, 19 able to attend the conference. The present recommendations, based on the most recent and relevant data available in literature as well as expert opinions, successively address multiple specific and problematic issues associated with the AMS800™ trough a eight-chapter structure: pre-operative assessment, pre operative challenges, implantation technique, post-operative care, trouble-shooting, outcomes, special populations, and the future of AUSs.
These guidelines undoubtedly constitute a reference document, which will help urologists to carefully select patients and apply the most adapted management to implantation, follow-up and trouble-shooting of the AMS800™.
AMS800™装置是目前全球植入最为频繁的人工尿道括约肌（AUS），在考虑男性尿失禁手术治疗时被视为“金标准”。尽管已有40年的使用经验，但它仍是一项存在诸多挑战的专业手术。在此，我们介绍AUS共识小组发布的关于AMS800™植入或翻修的适应证、管理及随访的建议。
在国际尿控学会（ICS）的支持下，一个专家小组于2015年7月10日在美国伊利诺伊州芝加哥市召开会议，试图就与AMS800™装置相关的各种问题达成共识。参与者由两位联合主席根据他们在大学医院的实践经验以及植入AUS的数量（根据美国医学系统控股公司（AMS，明尼通卡，明尼苏达州）的记录）和/或主要发表文章来挑选。列出的主题是所有参与者会前电子邮件头脑风暴的结果。联合主席将主题随机分发给所有参与者，然后他们必须就每个主题提出一份声明，在可能的情况下，经过简短的循证陈述后供会议批准。
共邀请了25位泌尿科医生参加，19位能够出席会议。基于文献中最新和相关的数据以及专家意见，本建议通过八章结构依次阐述了与AMS800™相关的多个具体和有问题的问题：术前评估、术前挑战、植入技术、术后护理、故障排除、结果、特殊人群以及AUS的未来。
这些指南无疑构成了一份参考文件，将有助于泌尿科医生仔细挑选患者，并对AMS800™的植入、随访和故障排除应用最适宜的管理方法。
