Department of Urology and Andrology, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
Sci Rep. 2024 Sep 2;14(1):20332. doi: 10.1038/s41598-024-68313-x.
To demonstrate the prevalence and risk factors for overactive bladder symptoms associated with artificial urinary sphincter implantation, we investigated the patients who underwent primary artificial urinary sphincter implantation with severe urinary stress incontinence. Forty-eight patients who completely answered the questionnaires of the overactive bladder symptom score before surgery were included. Patient characteristics, urinary status at pre and 1, 3, 6, and 12 months post-device activation, and predictive factors for overactive bladder symptoms were examined. Sixty percent of the patients had preoperative overactive bladder symptoms. Until 12 months after device activation, 35-40% of all patients had overactive bladder symptoms. The rate of persistent and de novo postoperative overactive bladder symptoms was 44.8% and 26.3%, respectively. Daily pad use was not different between patients w/wo overactive bladder symptoms. The only risk factor for postoperative overactive bladder symptoms was a max cystometoric capacity < 200 mL measured by a preoperative urodynamic study. Attention must be given to both persistent and de novo overactive bladder symptoms associated with artificial urinary sphincter implantation for patients with stress incontinence. Counsel should equally be provided for preoperative overactive bladder symptoms, especially in cases with a cystometric capacity < 200 mL.
为了展示与人工尿道括约肌植入相关的过度活动膀胱症状的流行率和风险因素,我们调查了因严重尿失禁而接受初次人工尿道括约肌植入的患者。共纳入 48 例完全回答术前过度活动膀胱症状评分问卷的患者。检查了患者特征、术前和术后 1、3、6 和 12 个月的尿状况,以及过度活动膀胱症状的预测因素。60%的患者术前有过度活动膀胱症状。在设备激活后 12 个月内,所有患者中有 35-40%有过度活动膀胱症状。持续性和新发术后过度活动膀胱症状的发生率分别为 44.8%和 26.3%。有/无过度活动膀胱症状的患者每日使用尿垫无差异。术前尿动力学研究测量的最大膀胱容量<200ml 是术后过度活动膀胱症状的唯一危险因素。对于压力性尿失禁患者,必须注意与人工尿道括约肌植入相关的持续性和新发过度活动膀胱症状。对于术前有过度活动膀胱症状的患者,应提供同样的咨询,特别是在膀胱容量<200ml 的情况下。