Centro Hospitalar Universitário de Santo António (CHUdSA), Porto.
Centro Hospitalar Universitário de São João (CHUSJ), Porto.
Arch Ital Urol Androl. 2024 Oct 2;96(3):12661. doi: 10.4081/aiua.2024.12661.
Radical prostate cancer treatment is the predominant cause of iatrogenic stress urinary incontinence (SUI) in men, significantly impacting their quality of life (QoL). This prospective single-center study in Portugal aimed to evaluate the outcomes of men with moderate-to-severe SUI treated with a single-component artificial urinary sphincter (AUS).
Male patients with iatrogenic moderate-to-severe SUI, determined by a 24-hour pad weight test, were included. The single-component device comprises a cuff linked to a pump unit through a kink-resistant tube. The implantation involved perineal incision for cuff placement and an inguinal incision for pump and tank positioning within the scrotum. Complications, pad usage, perioperative complications (Clavien-Dindo classification), and quality of life assessment using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire were documented.
Between May 2021 and March 2023, 20 consecutive single-component AUS insertions were conducted at a Portuguese urology department. Follow-up concluded in July 2023, with a mean follow-up duration of 15 months (range: 5-27). Four patients experienced complications necessitating device revision or removal (erosion = 2, infection = 1, mechanical failure = 1). Social continence (0/1 pad/day) was achieved in 70% (14/20 patients), while 30% (6/20 patients) experienced incontinence. Perioperatively, one patient was classified as grade 2, while the remaining were grade 0/1 in the Clavien-Dindo classification. The mean ICIQ-SF score reduction was 10.5 points.
The single-component AUS shows promising efficacy in managing moderate-to-severe male SUI, offering a good success rate, acceptable complications, improved QoL, and a straightforward surgical procedure.
前列腺癌根治术是男性医源性压力性尿失禁（SUI）的主要原因，显著影响其生活质量（QoL）。本研究为葡萄牙的一项单中心前瞻性研究，旨在评估采用单组件人工尿道括约肌（AUS）治疗中重度 SUI 男性患者的结局。
纳入因 24 小时尿垫试验确定为中重度 SUI 的男性患者。单组件装置由通过抗曲折管连接到泵单元的袖带组成。植入术涉及会阴切口以放置袖带，以及腹股沟切口以将泵和储液器置于阴囊内。记录并发症、尿垫使用情况、围手术期并发症（Clavien-Dindo 分类）以及采用国际尿失禁咨询问卷-短表（ICIQ-SF）问卷进行的生活质量评估。
2021 年 5 月至 2023 年 3 月期间，葡萄牙泌尿科开展了 20 例连续的单组件 AUS 植入术。随访于 2023 年 7 月结束，平均随访时间为 15 个月（范围：5-27 个月）。4 例患者因需要装置修正或移除而出现并发症（侵蚀=2 例，感染=1 例，机械故障=1 例）。70%（20 例患者中的 14 例）达到社交控尿（0/1 片/天），而 30%（20 例患者中的 6 例）仍存在尿失禁。Clavien-Dindo 分类中，围手术期 1 例患者为 2 级，其余均为 0/1 级。ICIQ-SF 评分平均降低 10.5 分。
单组件 AUS 在治疗中重度男性 SUI 方面显示出良好的疗效，成功率高，并发症可接受，生活质量改善，手术操作简单。
