Estaphanous Peter, Khalifa Ahmed O
Urology, University Hospital Coventry and Warwickshire, Coventry, GBR.
Urology, Sunderland Royal Hospital, Sunderland, GBR.
Cureus. 2024 Nov 6;16(11):e73136. doi: 10.7759/cureus.73136. eCollection 2024 Nov.
Stress urinary incontinence (SUI) significantly affects the quality of life in women, causing social, psychological, and physical distress. While artificial urinary sphincter (AUS) implantation is a well-established treatment for male incontinence, it is less commonly used in female patients and is typically considered for cases where other treatments have failed. This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of AUS implantation in treating SUI in female patients, focusing on continence rates, revision rates, explant rates, and perioperative complications. A comprehensive literature search was conducted across PubMed, Scopus, Google Scholar, and the Cochrane Library in September 2024. Studies published in English over the past 15 years were included if they reported outcomes such as continence, revision, explant, and complication rates in female patients who underwent AUS implantation. Data were analyzed using Review Manager 5.4, applying a fixed-effects model where appropriate, based on heterogeneity (I > 50%). Publication bias was assessed using funnel plots and Egger's test. Eight studies, comprising a total of 300 female patients, were included in the analysis. AUS implantation significantly improved continence rates, achieving an overall continence rate of 72% (OR = 0.01, 95% CI: 0.00 to 0.02; p < 0.00001). Revision rates were 22.5%, explant rates were 17.6%, and overall postoperative complications were 26.3%. No significant bias was detected. AUS implantation is an effective and safe treatment option for a specific group of women with SUI, particularly in cases where other standard treatments have failed. It shows satisfactory continence rates with considerable revision and explant rates. However, further large-scale, long-term studies are needed to optimize outcomes and confirm these findings.
压力性尿失禁（SUI）严重影响女性的生活质量，导致社交、心理和身体上的困扰。虽然人工尿道括约肌（AUS）植入术是治疗男性尿失禁的一种成熟方法，但在女性患者中使用较少，通常用于其他治疗失败的病例。本系统评价和荟萃分析旨在评估AUS植入术治疗女性SUI的有效性和安全性，重点关注控尿率、翻修率、取出率和围手术期并发症。2024年9月在PubMed、Scopus、谷歌学术和考克兰图书馆进行了全面的文献检索。纳入过去15年发表的英文研究，这些研究报告了接受AUS植入术的女性患者的控尿、翻修、取出和并发症发生率等结果。使用Review Manager 5.4进行数据分析，根据异质性（I²>50%）在适当情况下应用固定效应模型。使用漏斗图和Egger检验评估发表偏倚。分析纳入了8项研究，共300名女性患者。AUS植入术显著提高了控尿率总体控尿率达到72%（OR=0.01，95%CI：0.00至0.02；p<0.00001）。翻修率为22.5%，取出率为17.6%，术后总体并发症为26.3%。未检测到显著偏倚。对于特定的女性SUI患者群体，AUS植入术是一种有效且安全的治疗选择，特别是在其他标准治疗失败的情况下。它显示出令人满意的控尿率，但翻修和取出率也相当高。然而，需要进一步的大规模、长期研究来优化结果并证实这些发现。
