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女性可调节性控尿治疗球囊:植入后24个月内疗效的演变

[Adjustable continence therapy balloons in women: Evolution of efficacy within the 24 months following implantation].

作者信息

Guiffart P, Reix B, Martin-Malburet A, Marcelli F, Biardeau X

机构信息

Service d'urologie et d'andrologie, hôpital Claude Huriez, université Lille, CHU Lille, 59000 Lille, France.

Service d'urologie et d'andrologie, hôpital Claude Huriez, université Lille, CHU Lille, 59000 Lille, France.

出版信息

Prog Urol. 2018 Dec;28(16):927-934. doi: 10.1016/j.purol.2018.09.003. Epub 2018 Oct 10.

Abstract

PURPOSE

To analyze the functional outcomes over time of ACT balloon in women with stress urinary incontinence (SUI) secondary to intrinsic sphincter deficiency (ISD).

METHOD

All patients with SUI secondary to ISD who underwent bilateral ACT balloon implantation between September 2008 and November 2015 and regularly monitored for a period of at least 24 months were eligible. The results were studied at 6, 12 and 24 months. Efficacy was defined as: Success - maximum 1 safety pad per day and visual analogue scale (VAS) rating≥9/10. Improvement - decrease in the number of pads used per day and VAS≥5/10. Failure - increase or stability of the number of pads used per day and/or VAS<5/10. Failure was considered as primary when it occurred without any success or improvement. It was considered as secondary when it occurred after an initial period of success or improvement.

RESULTS

18 patients were monitored during 24 months. The success rate was respectively 17 %, 33 % and 33 % at 6, 12 and 24 months of follow-up. The improvement rate was respectively 61 %, 39 % and 17 % at 6, 12 and 24 months of follow-up. The primary failure rate was 22 %. The secondary failure rate was 6 % at 12 months and 33 % at 24 months of follow-up.

CONCLUSION

ACT balloon efficacy tends to decrease with time requiring a long-term follow-up of implanted patients.

LEVEL OF EVIDENCE

摘要

目的

分析针对内在括约肌缺陷(ISD)所致压力性尿失禁(SUI)女性患者,随时间推移ACT球囊的功能结局。

方法

所有2008年9月至2015年11月间接受双侧ACT球囊植入且继发于ISD的SUI患者,定期监测至少24个月者符合条件。在6、12和24个月时研究结果。疗效定义为:成功——每天最多使用1片安全护垫且视觉模拟量表(VAS)评分≥9/10。改善——每天使用护垫数量减少且VAS≥5/10。失败——每天使用护垫数量增加或稳定且/或VAS<5/10。未取得任何成功或改善即发生失败被视为原发性失败。在最初取得成功或改善后发生失败被视为继发性失败。

结果

18例患者接受了24个月的监测。随访6、12和24个月时成功率分别为17%、33%和33%。随访6、12和24个月时改善率分别为61%、39%和17%。原发性失败率为22%。随访12个月时继发性失败率为6%,24个月时为33%。

结论

ACT球囊疗效随时间趋于下降,需要对植入患者进行长期随访。

证据级别

4级。

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