Washington University in St. Louis, St. Louis, MO.
Washington University in St. Louis, St. Louis, MO.
Urology. 2024 Jun;188:144-149. doi: 10.1016/j.urology.2024.04.013. Epub 2024 Apr 20.
To determine better in-office measures for artificial urinary sphincter outcomes, we investigated the ability of preoperative timed peg-transfer, pinch strength, grip strength, and Disabilities of the Arm Shoulder and Hand Outcome questionnaire in predicting postoperative satisfaction, confidence, and ease of use of artificial urinary sphincter placement for stress urinary incontinence.
A timed 9-hole peg test, pinch and grip strength assessment, and upper extremity questionnaire were administered during the preoperative visit before sphincter placement. In addition to standard preoperative workup, short-form International Consultation of Incontinence Questionnaire and physician handshake were recorded. Activation occurred 6 weeks after surgery along with assessment of adequacy of pump placement. Three months from surgery a repeat incontinence questionnaire and a survey measuring satisfaction, difficulty of use, and confidence were given. Correlation between preoperative assessment variables and the postoperative questionnaire was assessed.
Thirty-nine patients were included. Average age and body mass index were 68.8 years and 28.8 kg/m, respectively. Prior prostatectomy accounted for 92.3% of patients, and 46.2% had prior pelvic radiation. Postoperatively, 59.0% of patients were very satisfied; 64.1% of patients reported no difficulty of use; 53.8% felt confidence within 1 day; and 66.7% had much better bladder control. Average pad improvement count was 5.3. Pinch test was associated with satisfaction (P = .011) while peg test was associated with confidence (P = .049). Handshake and upper extremity questionnaire were not significant.
The pinch and 9-hole peg transfer tests are cost-effective and easily performed adjuncts that could be used during artificial urinary sphincter evaluation for patients with unclear manual functional status.
为了确定人工尿道括约肌结局的更好的门诊测量方法，我们研究了术前定时 peg 转移、捏力、握力以及手臂肩手残疾问卷在预测压力性尿失禁患者人工尿道括约肌植入术后满意度、信心和易用性方面的能力。
在括约肌植入术前就诊时进行定时 9 孔 peg 测试、捏力和握力评估以及上肢问卷。除了标准的术前检查外，还记录了简短的国际尿失禁咨询问卷和医生握手。术后 6 周进行激活，同时评估泵放置是否充分。术后 3 个月进行重复尿失禁问卷和一项测量满意度、使用难度和信心的调查。评估术前评估变量与术后问卷之间的相关性。
共纳入 39 例患者。平均年龄和体重指数分别为 68.8 岁和 28.8 kg/m2。92.3%的患者既往行前列腺切除术，46.2%的患者有盆腔放疗史。术后，59.0%的患者非常满意；64.1%的患者报告无使用难度；53.8%的患者在 1 天内感到有信心；66.7%的患者膀胱控制能力明显改善。平均垫改善计数为 5.3。捏力测试与满意度相关（P=.011），而 peg 测试与信心相关（P=.049）。握手和上肢问卷无显著相关性。
捏力和 9 孔 peg 转移测试是具有成本效益且易于实施的辅助检查方法，可用于评估手部功能状态不明确的人工尿道括约肌患者。
