同期阴茎假体植入术和尿失禁手术的并发症发生率:比较阴茎阴囊入路与会阴入路。

Complication rates in concurrent inflatable penile prosthesis and incontinence surgery: Comparing the penoscrotal versus perineal incision approach.

机构信息

Department of Surgery, Division of Urology, University of Texas McGovern Medical School, Houston, TX, USA.

Department of Urology, MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Int J Impot Res. 2024 Feb;36(1):89-93. doi: 10.1038/s41443-022-00628-7. Epub 2022 Nov 10.

Abstract

The main objective of this study was to assess the IPP complication rates of patients undergoing placement via perineal incision versus more traditional penoscrotal approach in synchronous dual implantation. We identified 38 patients who underwent dual implantations of an IPP and AUS or urethral sling from 2011 to 2021 at a single tertiary center, 24 via perineal and 14 via penoscrotal incision. All IPP implants were done by a single surgeon. IPP postoperative complications were captured using the Clavien-Dindo classification at three separate time points, < 30 days, 30 days - 6 months, and > 6 months. The perineal group had two complications, IPP explantation due to rectourethral fistula (Grade III, > 6 months), and IPP explantation due to chronic genital pain (Grade III, > 6 months). The penoscrotal group had three complications, post-operative urinary retention requiring catheterization (Grade I, < 30 days), incision site infection (Grade I, < 30 days), and IPP explantation due to infection (Grade III, 30 days to < 6 months). There was no statistically significant difference in rate of patients with IPP complications between the two groups (p = 0.546) or in rate of IPP device malfunction (p = 0.264). These preliminary findings suggest that the single perineal incision is a viable surgical approach in synchronous dual implantation.

摘要

本研究的主要目的是评估经会阴切口与更传统的阴茎阴囊入路在同期双重植入中患者的 IPP 并发症发生率。我们在一家单一的三级中心确定了 38 名接受 IPP 和 AUS 或尿道吊带双重植入的患者,其中 24 名经会阴入路,14 名经阴茎阴囊入路。所有的 IPP 植入都是由一位外科医生完成的。我们使用 Clavien-Dindo 分类在三个不同的时间点(<30 天、30 天至 6 个月和>6 个月)来记录 IPP 术后并发症。会阴组有 2 种并发症,因直肠尿道瘘(III 级,>6 个月)而进行 IPP 摘除,因慢性生殖器疼痛(III 级,>6 个月)而进行 IPP 摘除。阴茎阴囊组有 3 种并发症,术后尿潴留需导尿(I 级,<30 天)、切口感染(I 级,<30 天)和因感染而进行 IPP 摘除(III 级,30 天至<6 个月)。两组患者 IPP 并发症发生率(p=0.546)或 IPP 设备故障发生率(p=0.264)无统计学差异。这些初步发现表明,单一的会阴切口是同期双重植入的一种可行的手术方法。

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