Pyrgidis Nikolaos, Barham David W, Hammad Muhammed, Sokolakis Ioannis, Hatzichristodoulou Georgios, Lentz Aaron C, Simhan Jay, Yafi Faysal A, Gross Martin S
Department of Urology, 'Martha-Maria' Hospital Nuremberg, Nuremberg, Germany.
Department of Urology, University of California, Irvine, Orange, CA, USA.
Sex Med Rev. 2022 Oct;10(4):782-790. doi: 10.1016/j.sxmr.2022.08.003. Epub 2022 Sep 26.
The efficacy, safety, and postoperative outcomes of synchronous surgery for concomitant erectile dysfunction (ED) and stress urinary incontinence (SUI) remain unclear.
We performed a systematic review and meta-analysis to evaluate the available synchronous surgical approaches for concomitant ED and SUI and to assess the reoperation rates compared to asynchronous surgery and surgery only for ED or SUI.
We searched PubMed, Cochrane Library, and Embase databases until June 2022 for relevant studies. Based on data availability, we performed a meta-analysis of odds ratios (ORs) comparing reoperation rates after synchronous surgery in patients with concomitant ED and SUI versus asynchronous surgery, as well as surgery solely for ED or SUI (PROSPERO: CRD42022326941).
We included 18 studies in the systematic review (16,517 patients) and 5 in the meta-analysis. Comparing synchronous implantation of penile prosthesis and artificial urinary sphincter (AUS) versus asynchronous surgery, no statistically significant differences were observed in the reoperation rates [OR:0.98, 95% confidence interval (CI): 0.52-1.84, I:0%). Comparing synchronous implantation of both penile prosthesis and AUS versus implantation of only a penile prosthesis or an AUS, combined surgery was associated with higher reoperation rates (OR:2.02, 95%CI: 1.29-3.16, I:36% and OR:1.7, 95%CI: 1.25-2.32, I:0%, respectively). Synchronous surgery led to high satisfaction rates and significant improvement in ED and SUI. Evidence for the combination of penile prosthesis with a male sling or the ProACT device is low, but data suggests it may be safe and effective. The synchronous placement of a Mini-Jupette sling and penile prosthesis represents a promising treatment modality for the correction of ED and mild SUI and/or climacturia.
Synchronous penile prosthesis and AUS implantation appears safe and effective in patients with severe ED and SUI. Further high-quality studies are mandatory to strengthen the current scarce evidence for synchronous surgery in patients with ED and SUI. Pyrgidis N, Barham DW, Hammad M, et al. Synchronous Surgical Management of Erectile Dysfunction and Stress Urinary Incontinence: A Systematic Review and Meta-Analysis of Reoperation Rates. Sex Med Rev 2022;10:782-790.
同时存在勃起功能障碍（ED）和压力性尿失禁（SUI）的同步手术的疗效、安全性及术后结果仍不明确。
我们进行了一项系统评价和荟萃分析，以评估针对ED和SUI的现有同步手术方法，并评估与非同步手术以及仅针对ED或SUI的手术相比的再次手术率。
我们检索了截至2022年6月的PubMed、Cochrane图书馆和Embase数据库中的相关研究。根据数据可用性，我们对合并ED和SUI患者同步手术后与非同步手术以及仅针对ED或SUI的手术的再次手术率进行了比值比（OR）的荟萃分析（国际前瞻性系统评价注册库：CRD42022326941）。
我们在系统评价中纳入了18项研究（16517例患者），在荟萃分析中纳入了5项研究。比较阴茎假体和人工尿道括约肌（AUS）同步植入与非同步手术，再次手术率无统计学显著差异[OR：0.98，95%置信区间（CI）：0.52 - 1.84，I²：0%]。比较阴茎假体和AUS同步植入与仅植入阴茎假体或AUS，联合手术的再次手术率更高（分别为OR：2.02，95%CI：1.29 - 3.16，I²：36%和OR：1.7，95%CI：1.25 - 2.32，I²：0%）。同步手术导致高满意率以及ED和SUI的显著改善。阴茎假体与男性吊带或ProACT装置联合使用的证据较少，但数据表明其可能是安全有效的。Mini-Jupette吊带和阴茎假体的同步放置是纠正ED和轻度SUI及/或更年期尿频的一种有前景的治疗方式。
阴茎假体和AUS同步植入在重度ED和SUI患者中似乎是安全有效的。需要进一步的高质量研究来加强目前关于ED和SUI患者同步手术的稀缺证据。皮尔吉迪斯N、巴拉姆DW、哈马德M等。勃起功能障碍和压力性尿失禁的同步手术治疗：再次手术率的系统评价和荟萃分析。性医学评论2022；10：782 - 790。
Zotero 插件