Szopiński Tomasz, Sudoł-Szopińska Iwona, Czech Anna K, Gąsowski Jerzy, Chłosta Piotr L
Department of Urology, Collegium Medicum, Jagiellonian University, Krakow, Poland.
Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Arch Med Sci. 2020 Feb 4;18(5):1279-1285. doi: 10.5114/aoms.2019.90803. eCollection 2022.
Artificial urinary sphincter (AUS) implantation is the treatment of choice for male urinary incontinence (UI). The aim of the present study was to evaluate treatment outcomes of UI in men using an AUS with a cuff placed around the prostatic urethra.
Forty-three men with preserved prostatic urethra were selected for AUS implantation due to UI. Twenty patients had the cuff implanted around the prostate using the retropubic approach (Group 1), and 23 had the cuff placed around the bulbous urethra (Group 2). Both groups were compared in terms of continence quality as well as intra- and postoperative complications.
The groups were comparable with respect to age and duration of follow-up. Median time to complications was 90.3 and 10.7 months in Group 1 and Group 2, respectively ( = 0.007). The complication rate was 40% and 58.3% in Group 1 and 2, respectively ( = 0.001). Complete continence was obtained in 80% of patients from Group 1 and 33.3% of men from Group 2A ( = 0.001).
The analysis indicates that cuff placement around the prostatic urethra results in better continence and is characterised by fewer complications. This method is dedicated for patients who have not had the prostate gland removed. Due to the retrospective nature of this analysis and small groups of patients, it is not possible to formulate ultimate recommendations.
人工尿道括约肌（AUS）植入术是男性尿失禁（UI）的首选治疗方法。本研究的目的是评估使用环绕前列腺尿道放置袖带的AUS治疗男性尿失禁的效果。
因尿失禁选择43例前列腺尿道保留的男性进行AUS植入术。20例患者采用耻骨后入路将袖带植入前列腺周围（第1组），23例患者将袖带放置在球部尿道周围（第2组）。比较两组的控尿质量以及术中和术后并发症。
两组在年龄和随访时间方面具有可比性。第1组和第2组并发症的中位时间分别为90.3个月和10.7个月（P = 0.007）。第1组和第2组的并发症发生率分别为40%和58.3%（P = 0.001）。第1组80%的患者和第2A组33.3%的男性实现了完全控尿（P = 0.001）。
分析表明，在前列腺尿道周围放置袖带可实现更好的控尿，且并发症较少。该方法适用于未切除前列腺的患者。由于本分析的回顾性性质以及患者数量较少，无法给出最终建议。
