Siracusano Salvatore, Visalli Francesco, Favro Michele, Tallarigo Carlo, Saccomanni Mauro, Kugler Alexander, Diminutto Alberto, Talamini Renato, Artibani Walter
Department of Urology, University of Verona, Italy.
Department of Urology, Hospital of Pordenone, Italy.
Urology. 2017 Dec;110:177-183. doi: 10.1016/j.urology.2017.07.058. Epub 2017 Sep 13.
To evaluate the short-term results with Argus-T sling in patients with post-prostatectomy incontinence (PPI).
A total of 182 patients with PPI were treated with Argus-T sling at 5 urologic centers from June 2008 to March 2013. The preoperative evaluation included medical history, pad count (1-2 pads: mild PPI; 3-5 pads: moderate PPI; >5 pads: severe PPI), visual analog scale on continence, quality of life score scale, physical examination, cystoscopy, and urodynamic evaluation. Postoperative evaluation was performed 6 weeks postoperatively, and late follow-up was achieved in April 2013. We considered a successful result when patients were cured (0-1 pads/24 hours) and or improved (1-2 pads/24 hours or a reduction in pad per day usage greater than 50%).
Twenty-one (11.8%), 96 (52.7%), and 65 (35.7%) patients have mild, moderate, and severe incontinence, respectively. At the median follow-up of 22 months, the overall success rate was 86.2%. We obtained successful results of 95% in mild incontinence, 78% in moderate incontinence and 70% in severe incontinence. In cured and improved patients, we observed a statistically significant amelioration of quality of life (P <.0001). Sling regulation was carried out in 42.9% of cases, whereas its removal occurred in 9.3% of cases. Postoperative complications were reported in 14.3% of patients. In patients with previous radiotherapy, we observed a successful result in 61.2% of cases.
This study represents the first report that shows short-term results of Argus-T positioning in a large population. Argus-T seems to offer good outcomes in patients with mild and moderate PPI.
评估Argus-T吊带治疗前列腺切除术后尿失禁（PPI）患者的短期疗效。
2008年6月至2013年3月期间，5家泌尿中心共182例PPI患者接受了Argus-T吊带治疗。术前评估包括病史、尿垫计数（1 - 2片尿垫：轻度PPI；3 - 5片尿垫：中度PPI；>5片尿垫：重度PPI）、尿失禁视觉模拟量表、生活质量评分量表、体格检查、膀胱镜检查和尿动力学评估。术后6周进行术后评估，并于2013年4月进行远期随访。当患者治愈（0 - 1片尿垫/24小时）和/或改善（1 - 2片尿垫/24小时或每日尿垫使用量减少超过50%）时，我们认为结果成功。
分别有21例（11.8%）、96例（52.7%）和65例（35.7%）患者存在轻度、中度和重度尿失禁。在中位随访22个月时，总体成功率为86.2%。轻度尿失禁的成功率为95%，中度尿失禁为78%，重度尿失禁为70%。在治愈和改善的患者中，我们观察到生活质量有统计学意义的改善（P <.0001）。42.9%的病例进行了吊带调整，而9.3%的病例进行了吊带移除。14.3%的患者报告了术后并发症。在既往接受过放疗的患者中，61.2%的病例结果成功。
本研究是首次报道Argus-T定位在大量患者中的短期疗效。Argus-T似乎为轻度和中度PPI患者提供了良好的治疗效果。
