Department of Urology, Nouvel Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 1 place de l'Hôpital, 67000, Strasbourg, France.
World J Urol. 2021 Jan;39(1):157-162. doi: 10.1007/s00345-020-03105-2. Epub 2020 Feb 12.
To report the outcomes of AUS in women with neurological SUI resulting from intrinsic sphincter deficiency after a follow-up from 3 to 20 years.
The charts of female with moderate to severe neurological SUI who underwent open or laparoscopic AUS implantation between November 1994 and July 2014 were reviewed retrospectively. All patients were operated by a single experienced surgeon. Primary endpoint was a postoperative continence categorized as complete continence (no pads used), improved incontinence or unchanged incontinence.
Twenty-three women (mean age 54 years, range 19-77) underwent open or laparoscopic AUS implantation. At the last follow-up, 7 (30.4%) initial artificial urinary sphincters remained in situ and 9 (39.1%) patients had at least one revision or reimplantation. Sixteen patients were fully continent (69.6%), four (17.4%) had improved incontinence and three (13.0%) had unchanged incontinence. After a median follow-up of 11.6 years (3-22), 8 (34.8%) explanations in 7 patients and 16 (69.6%) revisions in 11 patients occurred. The average time without explanation or revision was 10.9 and 8.5 years, respectively. Survival rates without AUS explanation were 94.4%, 76.5%, 72.8%, 50% and without revision were 83.3%, 64.7%, 45.5% and 16.7% at 5, 10, 15 and 20 years, respectively.
Although all methods are imperfect at best, AUS remain toward our experience a good way to achieve long-term continence in female patients suffering from neurological SUI with preserved manual dexterity.
报告 3 至 20 年后随访结果，评估应用逼尿肌吊带术（AUS）治疗因固有括约肌缺陷导致的女性神经源性压力性尿失禁（SUI）的效果。
回顾性分析 1994 年 11 月至 2014 年 7 月间接受开放或腹腔镜 AUS 植入术的中重度神经源性 SUI 女性患者的病历资料。所有患者均由同一位经验丰富的外科医生进行手术。主要终点为术后控尿效果，分为完全控尿（不使用尿垫）、控尿改善和控尿不变。
23 例女性患者（平均年龄 54 岁，范围 19-77 岁）接受了开放或腹腔镜 AUS 植入术。末次随访时，7 例（30.4%）初始人工尿道括约肌仍在位，9 例（39.1%）患者至少进行过 1 次修复或再植入。16 例患者完全控尿（69.6%），4 例（17.4%）控尿改善，3 例（13.0%）控尿不变。中位随访 11.6 年后（3-22 年），7 例患者中有 8 次（34.8%）需解释，11 例患者中有 16 次（69.6%）需修复。无需解释或修复的平均时间分别为 10.9 年和 8.5 年。无 AUS 解释的生存率分别为 94.4%、76.5%、72.8%、50%，无修复的生存率分别为 83.3%、64.7%、45.5%、16.7%，分别在 5、10、15 和 20 年后。
尽管所有方法都不完美，但根据我们的经验，AUS 仍然是一种治疗保留手部灵巧性的女性神经源性 SUI 的有效方法，可以实现长期控尿。
