Scott F B
Clin Obstet Gynaecol. 1985 Jun;12(2):415-29.
Data analysis of my experience with the implantation of the artificial sphincter shows an overall success rate of 84%. These results are in 139 females ranging from 5 to 84 years of age. The surgery is difficult primarily because the urethral-vaginal septum is not a surgical plane. Even partial injury to these tissues can lead to failure with erosion of the device into the urethra or vagina. The use of a new surgical instrument, the 'cutter clamp' (Figure 8A-F), is expected to improve results because of the precision it offers in dissecting around the bladder neck. Infection occurred in four out of 139, or 3% of the cases. In one infected case, the cuff eroded into the urethra. The infection rate may actually be higher since infection might account for some of the other erosions which occurred. Once erosion occurs, secondary infection can obscure the fact that the device was contaminated at the time of the original implantation. The use of a surgical isolation bubble system may lower both the incidence of infection and erosions in the future. The relief to the totally incontinent female by the artificial sphincter cannot be overestimated. The patients are very grateful, especially since most have undergone multiple treatment methods in an effort to cure their incontinence. The effectiveness of the device, barring infection or erosion, is evident by a success of 91% of such patients being socially continent and 66% being completely dry.
对我植入人工括约肌经验的数据分析显示总体成功率为84%。这些结果来自139名年龄在5岁至84岁之间的女性。该手术难度较大，主要是因为尿道阴道隔不是一个手术平面。即使这些组织受到部分损伤也可能导致手术失败，使装置侵蚀到尿道或阴道。使用一种新型手术器械“切割钳”（图8A - F），由于其在膀胱颈周围解剖时具有的精确性，有望改善手术结果。139例中有4例发生感染，占病例的3%。在1例感染病例中，袖带侵蚀到尿道。实际感染率可能更高，因为感染可能是其他一些发生的侵蚀的原因。一旦发生侵蚀，继发感染可能掩盖装置在最初植入时就已被污染的事实。使用手术隔离气泡系统可能会在未来降低感染和侵蚀的发生率。人工括约肌给完全失禁女性带来的缓解效果再怎么高估都不为过。患者非常感激，尤其是因为大多数患者为了治愈失禁已经接受了多种治疗方法。排除感染或侵蚀因素，该装置的有效性明显，91%的此类患者在社交场合能够控制排尿，66%的患者完全干爽。
