Dubois Alexandre, Lethuillier Valentine, Richard Claire, Haudebert Camille, Penafiel Juan, Voiry Caroline, Jezequel Magali, Emmanuel Emmanuelle, Berthelot Ouis-Paul, Freton Lucas, Hascoet Juliette, Manunta Andrea, Peyronnet Benoit
Department of Urology, University of Rennes, Rennes, France.
Department of Physical Medicine and Rehabilitation, University of Rennes, Rennes, France.
Int Neurourol J. 2024 Dec;28(4):294-301. doi: 10.5213/inj.2448372.186. Epub 2024 Dec 31.
While pump manipulation is rarely problematic in male patients with artificial urinary sphincters (AUSs), the situation may differ in female patients due to anatomical or cultural factors. This study aimed to evaluate the prevalence of difficulties in pump manipulation among female AUS patients, identify associated risk factors, and explore management strategies for this challenging issue.
Data were collected from all female patients who underwent a robotic AUS implantation at a single academic center between 2014 and 2022. The primary endpoint was temporary difficulties, defined by at least one other short hospitalization to learn pump manipulation.
Out of the 88 female AUS patients included in the study, 20 experienced initial difficulties manipulating the pump, accounting for 22.7% of the group. Temporary difficulties were reported by 16 patients (18.2%), while 4 patients (4.5%) had their devices permanently deactivated. Surgical reoperations to reposition the pump were necessary for 5 patients, representing 5.6% of the sample. The only variables significantly associated with temporary difficulties were longer operative time (183.4 minutes vs. 159.1 minutes, P=0.04) and the overall experience of the center (32 vs. 50, P=0.04). The sole variable significantly linked to serious difficulties was the overall experience of the center (11 vs. 47, P=0.004). Although the median age and body mass index were higher in the group with temporary difficulties, these differences were not statistically significant.
Difficulties in manipulating the pump are relatively common among female AUS patients. Most of these difficulties can be resolved through repeated patient education and careful follow-up. However, some may lead to serious complications. Raising awareness of this issue, along with ongoing patient education and meticulous follow-up, may help to minimize these consequences.
虽然人工尿道括约肌（AUS）男性患者很少出现泵操作问题，但由于解剖或文化因素，女性患者的情况可能有所不同。本研究旨在评估女性AUS患者泵操作困难的发生率，确定相关危险因素，并探索针对这一具有挑战性问题的管理策略。
收集2014年至2022年期间在单一学术中心接受机器人AUS植入术的所有女性患者的数据。主要终点是暂时性困难，定义为至少因学习泵操作而再次短期住院。
在纳入研究的88名女性AUS患者中，20名患者最初在操作泵时遇到困难，占该组的22.7%。16名患者（18.2%）报告有暂时性困难，而4名患者（4.5%）的装置被永久停用。5名患者（占样本的5.6%）需要进行手术重新操作以重新定位泵。与暂时性困难显著相关的唯一变量是手术时间较长（183.4分钟对159.1分钟，P=0.04）和中心的整体经验（32对50，P=0.04）。与严重困难显著相关的唯一变量是中心的整体经验（11对47，P=0.004）。虽然有暂时性困难的组中位年龄和体重指数较高，但这些差异无统计学意义。
泵操作困难在女性AUS患者中相对常见。这些困难大多可通过反复的患者教育和仔细的随访得到解决。然而，有些困难可能会导致严重并发症。提高对这一问题的认识，以及持续的患者教育和细致的随访，可能有助于将这些后果降至最低。
