Westmead Private Physiotherapy Services, Westmead Private Hospital Sydney, Sydney, Australia.
The Clinical Research Institute, Sydney, Australia.
Investig Clin Urol. 2019 Sep;60(5):367-372. doi: 10.4111/icu.2019.60.5.367. Epub 2019 Aug 19.
To develop a cadaver model for the assessment of a male transobturator male sling (retrourethral transobturator sling [RTS], AdVance™; Boston Scientific, USA) to investigate its effect on a simulated abdominal and retrograde leak point pressures (ALPP, RLPP) and the urethral pressure profile (UPP).
Three fresh frozen human male cadaver specimens were obtained. A suprapubic tube was inserted into the bladder and connected to a digital manometer to measure bladder pressure. Manual suprapubic pressure was then applied to generate an increase in intraabdominal pressure and measure a simulated ALPP. Subsequent measurements of RLPP and UPP were recorded. All measurements were undertaken prior to and following insertion of a RTS.
The placement of the RTS consistently increased the simulated ALPP for all three cadaver specimens when compared to baseline measures. No leaks occurred at simulated ALPP's of 170 cm HO for specimen 1, 160 cm HO for specimen 2, and 170 cm HO for specimen 3. There was minimal or no change in the RLPP's and UPP's following insertion of the RTS when compared to respective baseline.
A model using fresh unfixed cadavers that incorporates a simulated measurement of ALPP is feasible for male stress urinary incontinence surgical intervention investigations.
开发一种评估经会阴男性吊带（Retrourethral Transobturator Sling [RTS]，AdVance™；波士顿科学，美国）的尸体模型，以研究其对模拟腹压和逆行漏点压力（ALPP、RLPP）以及尿道压力曲线（UPP）的影响。
获得了三个新鲜冷冻的男性尸体标本。在膀胱内插入耻骨上管并连接数字测压计以测量膀胱压力。然后施加手动耻骨上压力以增加腹内压并测量模拟 ALPP。随后记录 RLPP 和 UPP 的测量值。所有测量均在插入 RTS 之前和之后进行。
与基线测量相比，RTS 的放置始终会增加所有三个尸体标本的模拟 ALPP。对于标本 1，模拟 ALPP 为 170cmHO；对于标本 2，模拟 ALPP 为 160cmHO；对于标本 3，模拟 ALPP 为 170cmHO，均未发生泄漏。与各自的基线相比，插入 RTS 后 RLPP 和 UPP 的变化很小或没有。
一种使用新鲜未固定尸体并包含模拟 ALPP 测量的模型可用于男性压力性尿失禁手术干预研究。
