Bolat Deniz, Kozacioglu Zafer, Polat Salih, Koras Omer, Arslan Murat, Minareci Suleyman
Department of Urology. Bozyaka Training and Research Hospital. Izmir. Turkey.
Department of Urology. Tepecik Training and Research Hospital. Izmir. Turkey.
Arch Esp Urol. 2017 Apr;70(3):367-372.
To evaluate the results of synchronous dual implantation of penile (PP) and artificial urinary sphincter prosthesis (AUSP) in patients with severe erectile dysfunction (ED) and urinary incontinence (UI) after radical prostatectomy (RP).
Between January 2006 and March 2015, patients who underwent synchronous dual implantation of PP for severe post-RP ED and AUSP for moderate to severe post-RP UI in our clinic were screened retrospectively. The erectile function and the continence status were evaluated by the questionnaires of IIEF-5 and ICIQ-SF. Results for the preoperative period and for the 1st postoperative year were revealed from patient charts. Long term results were evaluated by telephone interviews. Comorbidities, infection rates and complications were noted.
A total of 14 patients underwent synchronous dual implantation; out of which, 11 had a long enough follow up period for a sufficient long term evaluation. 3/11 had MPP and 8/11 had two-piece IPP implantation together with an AUSP. All of the implantations were carried out through an upper transverse scrotal incision. Mean follow up time was 61.3 ± 20 months. In 1 patient who had received adjuvant radiotherapy, both of the devices were removed due to infection and cuff erosion. Mean daily usage of pads diminished from 4 to 1 while ICIQ-SF score decreased from 19 to 2 and IIEF-5 score increased from 3 to 23.
Synchronous implantation of PP and AUSP is a safe and effective treatment option for patients with severe ED and moderate to severe UI after RP.
评估阴茎假体(PP)和人工尿道括约肌假体(AUSP)同步植入对根治性前列腺切除术(RP)后出现严重勃起功能障碍(ED)和尿失禁(UI)患者的治疗效果。
回顾性筛查2006年1月至2015年3月期间在我院因RP后严重ED接受PP同步植入以及因RP后中重度UI接受AUSP同步植入的患者。通过国际勃起功能指数-5(IIEF-5)问卷和国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-SF)评估勃起功能和控尿状态。从患者病历中获取术前及术后第1年的结果。通过电话访谈评估长期结果。记录合并症、感染率及并发症情况。
共有14例患者接受了同步双植入;其中11例有足够长的随访期以进行充分的长期评估。11例中有3例植入可膨胀性阴茎假体(MPP),8例植入两件式可膨胀阴茎假体(IPP)并同时植入AUSP。所有植入均通过阴囊上横切口进行。平均随访时间为61.3±20个月。1例接受辅助放疗的患者因感染和袖套侵蚀取出了两种装置。尿垫日均使用量从4片减少至1片,ICIQ-SF评分从19分降至2分,IIEF-5评分从3分升至23分。
PP和AUSP同步植入是RP后严重ED和中重度UI患者的一种安全有效的治疗选择。