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[男性人工尿道括约肌植入术的阴茎阴囊入路与会阴入路比较]

[Comparison of penoscrotal and perineal approaches for implantation of an artificial urinary sphincter in man].

作者信息

Brierre T, Roumiguie M, Soulie M, Rischmann P, Thoulouzan M, Game X

机构信息

Département d'Urologie, Transplantation Rénale et Andrologie, CHU Rangueil, TSA 50032, 31059 Toulouse, France.

Département d'Urologie, Transplantation Rénale et Andrologie, CHU Rangueil, TSA 50032, 31059 Toulouse, France.

出版信息

Prog Urol. 2021 Dec;31(17):1182-1191. doi: 10.1016/j.purol.2021.08.238. Epub 2021 Nov 18.

Abstract

INTRODUCTION

Artificial urinary sphincter is considered the gold standard of treatment for male urinary incontinence because of intrinsic sphincter deficiency. The objective of our study was to compare the functional results and complications of the penoscrotal and perineal incision for the implantation of artificial urinary sphincter.

MATERIAL AND METHODS

A retrospective, monocentric study comparing the perioperative and long-term results of primary implantation of an artificial urinary sphincter in men, performed by the penoscrotal or the perineal incision, was conducted in a French university hospital.

RESULTS

Between April 2004 and February 2019, 175 patients were implanted (118 by penoscrotal incision and 57 by perineal incision) by 19 surgeons. Cuff placement approach depended on surgeon preference. The average follow-up was 34.2 ± 35.6 months. Cuff size was smaller in the penoscrotal group (4 [4;5] vs 4.5[4;5] p<0.001). At the end of follow-up, the rates of complete continence, social continence, reintervention for any reason, explantation, and revision was similar between the two groups.

CONCLUSION

Long-term outcomes of penoscrotal and perineal artificial sphincter implantation were similar between the two groups. Prospective multicenter studies are needed to confirm these results.

摘要

引言

由于内在括约肌缺陷,人工尿道括约肌被认为是男性尿失禁治疗的金标准。我们研究的目的是比较阴茎阴囊切口和会阴切口植入人工尿道括约肌的功能结果和并发症。

材料与方法

在一家法国大学医院进行了一项回顾性、单中心研究,比较阴茎阴囊切口或会阴切口对男性进行人工尿道括约肌初次植入的围手术期和长期结果。

结果

2004年4月至2019年2月期间,19名外科医生为175例患者植入了人工尿道括约肌(118例采用阴茎阴囊切口,57例采用会阴切口)。袖带放置方法取决于外科医生的偏好。平均随访时间为34.2±35.6个月。阴茎阴囊组的袖带尺寸较小(4[4;5]对4.5[4;5],p<0.001)。随访结束时,两组之间的完全控尿率、社交控尿率、因任何原因再次干预率、取出率和翻修率相似。

结论

两组阴茎阴囊和会阴人工括约肌植入的长期结果相似。需要进行前瞻性多中心研究来证实这些结果。

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