Huang Tsu-Hsiu, Chang Tien-Lin, Jiang Yuan-Hong, Jhang Jia-Fong, Wang Jen-Hung, Kuo Hann-Chorng
Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, 707, Section 3, Chung Yang Road, Hualien, Taiwan.
Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 707, Section 3, Chung Yang Road, Hualien, Taiwan.
Int Urol Nephrol. 2025 Apr 25. doi: 10.1007/s11255-025-04539-6.
Stress urinary incontinence (SUI) is usually secondary to prostatectomy or neurological lesions in men. The results of male suburethral slings for treating male SUI are presented.
The patients with postprostatectomy incontinence (PPI) (n = 47) and neurogenic SUI (NSUI) (n = 20) underwent the suburethral sling procedure using a polypropylene mesh and cardiovascular patch. In patients with PPI, the retrograde leak point pressure (RLPP) was set at 50-60 cmHO, and in patients with NSUI, the RLPP was adjusted to no urine leakage without interfering catheterization. The treatment was considered successful when the patient achieved either complete or social continence at the 3-month follow-up. The revision and infection rates were also assessed.
The mean age of the cohort was 63.9 ± 16.5 years; the mean follow-up period was 40.1 ± 48.7 months. The success rate was 56.7% for the entire cohort, 57.4% for the PPI group, and 55% for the NSUI group. The patients with PPI who did not receive radiotherapy had a higher success rate (63%) than those who received prior radiotherapy (33%). Among patients for whom the suburethral sling procedure was successful, those with PPI had a higher BMI, whereas those with NSUI had a higher corrected Qmax and RLPP. No significant difference in baseline abdominal LPP was observed between the two groups.
The suburethral sling procedure is safe and effective for male patients with SUI. Although radiotherapy reduced the success rate, intraoperative RLPP measurement enabled effective tension adjustment, particularly in patients with NSUI.
压力性尿失禁（SUI）在男性中通常继发于前列腺切除术或神经病变。本文介绍了男性尿道下吊带治疗男性SUI的结果。
前列腺切除术后尿失禁（PPI）患者（n = 47）和神经源性SUI（NSUI）患者（n = 20）接受了使用聚丙烯网片和心血管补片的尿道下吊带手术。对于PPI患者，逆行漏点压力（RLPP）设定为50 - 60 cmH₂O，对于NSUI患者，在不干扰导尿的情况下将RLPP调整至无尿液漏出。当患者在3个月随访时达到完全或社交性控尿时，治疗被认为成功。还评估了翻修率和感染率。
该队列的平均年龄为63.9 ± 16.5岁；平均随访期为40.1 ± 48.7个月。整个队列的成功率为56.7%，PPI组为57.4%，NSUI组为55%。未接受放疗的PPI患者成功率（63%）高于接受过放疗的患者（33%）。在尿道下吊带手术成功的患者中，PPI患者的体重指数较高，而NSUI患者的校正Qmax和RLPP较高。两组之间基线腹部LPP无显著差异。
尿道下吊带手术对男性SUI患者安全有效。虽然放疗降低了成功率，但术中RLPP测量可实现有效的张力调整，特别是在NSUI患者中。
