男性神经源性尿失禁的机器人辅助尿道括约肌植入术的疗效

Outcomes of robot-assisted urinary sphincter implantation for male neurogenic urinary incontinence.

作者信息

Chartier-Kastler Emmanuel, Guillot-Tantay Cyrille, Ruggiero Marina, Cancrini Fabiana, Vaessen Christophe, Phé Véronique

机构信息

Department of Urology, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Academic Hospital, Sorbonne Université Medical School, Paris, France.

Department of Medical and Surgical Sciences and Translational Medicine, Sant 'Andrea University Hospital, Sapienza University of Rome, Rome, Italy.

出版信息

BJU Int. 2022 Feb;129(2):243-248. doi: 10.1111/bju.15528. Epub 2021 Jul 12.

DOI:10.1111/bju.15528

PMID:34174147

Abstract

OBJECTIVES

To report the functional outcomes of robot-assisted laparoscopic artificial urinary sphincter implantation (R-AUS) in men with neurogenic stress urinary incontinence (SUI).

PATIENTS AND METHODS

A monocentric retrospective study included all consecutive adult male neuro-urological patients who underwent R-AUS for SUI between January 2011 and August 2018. The AUS was implanted via a transperitoneal robot-assisted laparoscopic approach. Intraoperative and early postoperative complications were reported (Clavien-Dindo classification). Continence was defined as no pad usage. Revision and explantation rates were also evaluated.

RESULTS

Overall, 19 men with a median (interquartile range [IQR]) age of 45 (37-54) years were included. No conversion to laparotomy was needed. Three minor (Clavien-Dindo Grade I-II) early postoperative complications occurring in three (15.8%) patients were reported. The median (IQR) follow-up was 58 (36-70) months. At the end of the follow-up, the continence rate was 89.5%. The AUS revision and explantation rates were 5.3% and 0%, respectively.

CONCLUSION

A R-AUS is a safe and efficient procedure for AUS implantation in adult male neuro-urological patients, referring to the challenging open technique.

摘要

目的

报告机器人辅助腹腔镜人工尿道括约肌植入术（R-AUS）治疗男性神经源性压力性尿失禁（SUI）的功能结局。

患者与方法

一项单中心回顾性研究纳入了2011年1月至2018年8月间因SUI接受R-AUS手术的所有成年男性神经泌尿科连续患者。人工尿道括约肌通过经腹机器人辅助腹腔镜入路植入。报告术中及术后早期并发症（Clavien-Dindo分类）。控尿定义为无需使用尿垫。还评估了翻修率和取出率。

结果

共纳入19例男性患者，年龄中位数（四分位间距[IQR]）为45（37-54）岁。无需转为开腹手术。报告了3例（15.8%）患者发生3例轻微（Clavien-Dindo I-II级）术后早期并发症。随访时间中位数（IQR）为58（36-70）个月。随访结束时，控尿率为89.5%。人工尿道括约肌翻修率和取出率分别为5.3%和0%。