Cerniauskiene Ausra, Barisiene Marija, Bakavicius Arnas, Kavaliauskaite Ramune, Cekauskas Albertas, Zelvys Arunas
Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Centre of Urology, Vilnius University, Hospital Santaros Klinikos, Vilnius, Lithuania.
Wideochir Inne Tech Maloinwazyjne. 2020 Sep;15(3):496-502. doi: 10.5114/aoms.2020.97413. Epub 2020 Jul 16.
Argus suburethral sling implantation is a minimally invasive operation with the possibility to adjust the tension of the sling at any time after the procedure, which provides good treatment results for male stress urinary incontinence (SUI).
To determine the predictive factors, the incidence, severity and timing of the onset of complications after Argus sling implantation for males with post-operative SUI.
A total of 41 patients who underwent Argus sling implantation due to post-operative SUI were included. Median follow-up was 12 months. All complications were captured and graded according to severity and classified by timing of onset. Logistic regression analysis was performed to identify predictors of the most common side effects.
Overall 22 (54%) of 41 males have experienced 31 complications. Three (7%) patients have experienced only intra-operative, 16 (39%) patients only post-operative and 3 (7%) patients both intra-operative and post-operative complications. The most common intra-operative complications were bladder perforation (12%) and external iliac vein injury (5%), while post-operative complications were acute urinary retention (29%), infection (10%) and perineal pain (7%). Previous radiotherapy has significantly increased the risk of intra-operative complications, while a non-significant tendency was observed for younger age, previous androgen deprivation therapy and grade 3 SUI. In terms of severity, most post-operative complications were classified as grade 3 according to the modified Clavien-Dindo system.
Argus sling implantation provides a tolerable complication rate, where acute urinary retention was the most common side effect. Previous radiotherapy significantly increases the risk of serious intra-operative complications.
阿格斯尿道下吊带植入术是一种微创手术，术后可随时调整吊带张力，为男性压力性尿失禁（SUI）提供了良好的治疗效果。
确定阿格斯吊带植入术后男性SUI患者并发症发生的预测因素、发生率、严重程度及发生时间。
纳入41例因术后SUI接受阿格斯吊带植入术的患者。中位随访时间为12个月。记录所有并发症，并根据严重程度分级，按发生时间分类。进行逻辑回归分析以确定最常见副作用的预测因素。
41例男性患者中，共有22例（54%）发生了31例并发症。3例（7%）患者仅在术中出现并发症，16例（39%）患者仅在术后出现并发症，3例（7%）患者术中及术后均出现并发症。最常见的术中并发症是膀胱穿孔（12%）和髂外静脉损伤（5%），而术后并发症是急性尿潴留（29%）、感染（10%）和会阴部疼痛（7%）。既往放疗显著增加了术中并发症的风险，而年龄较小、既往雄激素剥夺治疗和3级SUI则有不显著的增加趋势。就严重程度而言，根据改良的Clavien-Dindo系统，大多数术后并发症被归类为3级。
阿格斯吊带植入术的并发症发生率可接受，其中急性尿潴留是最常见的副作用。既往放疗显著增加了严重术中并发症的风险。
