Romero Hoyuela A, Reina Alcaina L, Izquierdo Morejon E, Rosino Sanchez A, Carrillo George C, Rivero Guerra A, Barcelo Bayonas I, Pardo Martinez A, Muñoz Guillermo V, Pietricica B, Fernandez Aparicio T, Hita Villaplana G, Miñana Lopez B
Servicio de Urología, Hospital Universitario Morales Meseguer, Murcia, España.
Servicio de Urología, Hospital Universitario Morales Meseguer, Murcia, España.
Actas Urol Esp (Engl Ed). 2018 Apr;42(3):185-190. doi: 10.1016/j.acuro.2017.09.004. Epub 2017 Nov 11.
To analyse the safety, efficacy and quality of life of patients with male stress urinary incontinence after radical prostatectomy treated with the AdVance and AdvanceXP slings.
The study included 92 patients with stress urinary incontinence after radical prostatectomy treated with the AdVance and AdVanceXP sling between May 2008 and December 2015. A perineal repositioning test was performed in all cases with sphincter coaptation of≥1.5cm. Mild stress urinary incontinence was defined as the use of 1-2 absorbers/24h; moderate was defined as 3-5 absorbers/24h; and severe was defined as more than 5 absorbers/24h. Healing was defined as the total absence of using pads; improvement was defined as a reduction>50% in the number of pads; and failure was defined as a reduction<50, no improvement or worsened incontinence. Check-ups were conducted at 3, 12 and 36 months after the surgery. We employed the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) for the quality of life index. The complications are listed according to the Clavien-Dindo classification.
The degree of preoperative incontinence was mild in 23.9%, moderate in 67.4% and severe in 8.7% of the patients. The mean use of preoperative pads was 3.1 (range 1-6, 95% CI). The mean preoperative ICIQ-SF score was 16.5 (15-20). Sphincter coaptation≥1.5cm using the perineal repositioning test was present in 87 patients (94.6%). The mean follow-up from insertion of the sling was 42.1 months. Some 89.1% of the patients were healed at 3 months, 70.7% were healed at 12 months, and 70.4% were healed at 36 months. The ICIQ-SF score at 3, 12 and 36 months showed significant improvement (P<.001) compared with the preoperative score.
The Advance and AdvanceXP system are effective over time in terms of urinary continence and patient satisfaction.
分析接受AdVance和AdvanceXP吊带治疗的前列腺癌根治术后男性压力性尿失禁患者的安全性、有效性和生活质量。
本研究纳入了2008年5月至2015年12月期间接受AdVance和AdvanceXP吊带治疗的92例前列腺癌根治术后压力性尿失禁患者。所有病例均进行会阴复位试验，括约肌贴合度≥1.5cm。轻度压力性尿失禁定义为每24小时使用1 - 2片吸收垫；中度定义为每24小时使用3 - 5片吸收垫；重度定义为每24小时使用超过5片吸收垫。治愈定义为完全不使用护垫；改善定义为护垫使用数量减少>50%；失败定义为减少<50%、无改善或尿失禁加重。术后3、12和36个月进行检查。我们采用国际尿失禁咨询问卷简表（ICIQ - SF）评估生活质量指数。并发症按照Clavien - Dindo分类列出。
术前尿失禁程度为轻度的患者占23.9%，中度的占67.4%，重度的占8.7%。术前吸收垫平均使用量为3.1片（范围1 - 6片，95%置信区间）。术前ICIQ - SF平均评分为16.5分（15 - 20分）。87例患者（94.6%）通过会阴复位试验显示括约肌贴合度≥1.5cm。吊带置入后的平均随访时间为42.1个月。约89.1%的患者在3个月时治愈，70.7%在12个月时治愈，70.4%在36个月时治愈。与术前评分相比，3、12和36个月时的ICIQ - SF评分有显著改善（P<.001）。
随着时间推移，Advance和AdvanceXP系统在尿失禁控制和患者满意度方面是有效的。
