Urologie, Sorbonne Université, Hôpital Universitaire Pitié-Salpêtrière, 47-83 Boulevard de L'Hôpital, 75651, Paris Cedex 13, France.
Department of Urology, University of Montreal, Maisonneuve-Rosemont Hospital, Montreal, Canada.
World J Urol. 2023 Jun;41(6):1691-1696. doi: 10.1007/s00345-023-04399-8. Epub 2023 Apr 13.
Patients with artificial urinary eventually need surgical revision. Unfortunately, in women, this requires another invasive abdominal intervention. Robotic-assisted revision may provide a less invasive and more acceptable approach for sphincter revision in women. We wanted to determinate the continence status after robotic-assisted artificial urinary sphincter revision among women with stress incontinence. We also examined postoperative complications and the safety of the procedure.
The chart of the 31 women with stress urinary incontinence who underwent robotic-assisted AUS revision at our referral center from January 2015 to January 2022 were reviewed retrospectively. All patients underwent a robotic-assisted artificial urinary sphincter revision by one of our two expert surgeons. The primary outcome was to determinate the continence rate after revision and the secondary outcome aimed to evaluate the safety and feasibility of the procedure.
Mean patients age was 65 years old, and the mean time between the sphincter revision and previous implantation was 98 months. After a mean follow-up of 35 months, 75% of the patients were fully continent (0-pad). Moreover, 71% of the women were back to the same continence status as with the previously functional sphincter, while 14% even have an improved continence status. Clavien-Dindo grade [Formula: see text] 3 and overall complications occurred in 9% and 20.5% of our patients, respectively. This study is mainly limited by its retrospective design.
Robotic-assisted AUS revision carries satisfying outcome in terms of continence and safety.
人工尿道最终需要手术修正。不幸的是,对于女性来说,这需要另一次侵入性的腹部干预。机器人辅助修正可能为女性的括约肌修正提供一种侵入性更小、更能接受的方法。我们想确定在有压力性尿失禁的女性中,机器人辅助人工尿道括约肌修正后的尿控状况。我们还检查了术后并发症和手术的安全性。
回顾性分析了 2015 年 1 月至 2022 年 1 月期间,在我们的转诊中心接受机器人辅助 AUS 修正的 31 名有压力性尿失禁的女性的图表。所有患者均由我们的两位专家外科医生之一进行机器人辅助人工尿道括约肌修正。主要结果是确定修正后的尿控率,次要结果旨在评估该程序的安全性和可行性。
平均患者年龄为 65 岁,括约肌修正和先前植入之间的平均时间为 98 个月。平均随访 35 个月后,75%的患者完全尿控(0 垫)。此外,71%的女性回到了与先前功能正常的括约肌相同的尿控状态,而 14%的女性甚至有更好的尿控状态。Clavien-Dindo 分级[公式:见文本]3 和总体并发症分别发生在 9%和 20.5%的患者中。本研究主要受到回顾性设计的限制。
机器人辅助 AUS 修正在尿控和安全性方面具有令人满意的结果。