Yanaral Fatih, Gültekin Mehmet Hamza, Halis Ahmet, Akbulut Fatih, Sarilar Omer, Ozgor Faruk
Urology, Haseki Education and Research Hospital, Istanbul, TUR.
Cureus. 2023 Aug 10;15(8):e43280. doi: 10.7759/cureus.43280. eCollection 2023 Aug.
Objective To evaluate the outcomes of adjustable male sling (Argus®) implantation in the management of post-prostatectomy incontinence (PPI) with intermediate-term follow-up results. Materials and methods The data on adjustable male sling surgery between September 2015 and September 2020 were retrospectively analyzed. Patients were preoperatively evaluated with a voiding diary, 24-hour pad test, and validated questionnaire. Functional outcomes were also evaluated using 24-hour pad requirement and pad weight, and the International Consultation on Incontinence (ICIQ-SF) score. Results A total of 16 patients (eight having undergone the transurethral resection of the prostate [TUR-P] and eight radical prostatectomy [RP]) were enrolled in the study. Thirteen patients had moderate (81.25%) PPI, and three patients (18.75%) had severe PPI. With the mean follow-up of 36.9±14.3 months, nine patients (56.2%) were noted as cured and four (25%) as improved, with an overall success rate of 81.2%. At the last follow-up visit, the median number of pads used per day decreased from 3.5 to 1, and the 24-hour pad test result decreased from 300 to 50 gr (p < 0.001 and p < 0.001, respectively). The ICIQ-SF score decreased from the initial mean of 15.8 ± 2.3 to 7.1 ± 6.6 (p < 0.001). When the outcomes were compared according to the etiology, there was no statistically significant difference (p = 0.522). Conclusions Male sling surgery can be performed safely in patients with moderate and severe stress urinary incontinence with low complication and high success rates. The results of TUR-P-related PPI are similar to those of surgery performed due to the etiology of RP.
目的 评估可调节男性吊带(阿格斯®)植入术治疗前列腺切除术后尿失禁(PPI)的中期随访结果。材料与方法 回顾性分析2015年9月至2020年9月期间可调节男性吊带手术的数据。术前通过排尿日记、24小时尿垫试验和有效问卷对患者进行评估。还使用24小时尿垫需求量、尿垫重量和国际尿失禁咨询委员会(ICIQ-SF)评分评估功能结局。结果 共有16例患者(8例行经尿道前列腺切除术[TUR-P],8例行根治性前列腺切除术[RP])纳入研究。13例患者为中度PPI(81.25%),3例患者(18.75%)为重度PPI。平均随访36.9±14.3个月,9例患者(56.2%)治愈,4例(25%)改善,总成功率为81.2%。在最后一次随访时,每天使用尿垫的中位数从3.5片降至1片,24小时尿垫试验结果从300克降至50克(分别为p<0.001和p<0.001)。ICIQ-SF评分从最初的平均15.8±2.3降至7.1±6.6(p<0.001)。根据病因比较结局时,无统计学显著差异(p = 0.522)。结论 男性吊带手术可安全地用于中重度压力性尿失禁患者,并发症发生率低,成功率高。TUR-P相关PPI的结果与因RP病因进行手术的结果相似。