Hirose Hibiki, Tabei Tadashi, Araki Yushi, Ouchi Hideki, Nirei Takuma, Kobayashi Kazuki
Department of Urology, Fujisawa Shounandai Hospital, 2345, Takakura, Fujisawa, Kanagawa, 252-0802, Japan.
Yokosuka Kyousai Hospital, Yokosuka, Japan.
BMC Urol. 2025 Jul 18;25(1):176. doi: 10.1186/s12894-025-01871-y.
AUS implantation is the standard treatment recommended by the European Urological Association and American Urological Association guidelines to treat stress urinary incontinence due to intrinsic sphincter deficiency. AUS implantation following a neobladder construction or urethroplasty has been previously reported; however, there are only a few reports on patients who have undergone both procedures.This report presents a unique case of a patient who underwent artificial urinary sphincter (AUS) implantation after undergoing both urethroplasty and ileal neobladder construction.
A 76-year-old male with a history of urethral stricture and ileal neobladder construction was referred to our department because of persistent stress urinary incontinence. A pressure-regulating balloon was placed in the left lower abdomen, where the peritoneum remained intact. The AUS was activated and urinary continence was restored approximately seven weeks post-surgery. In addition to standard usage instructions, the patient was advised on timed voiding and deactivation during the night and in the event of fever. Urinary incontinence significantly improved, and the effectiveness was maintained without complications one year post-surgery. Device infection and urethral erosion are critical complications that should be considered during AUS implantation. We focused on the site of AUS implantation and perioperative infection control to solve this problem.
AUS implantation was performed in the patient who underwent both urethroplasty and ileal neobladder construction. We felt that meticulous measures during and after the perioperative period are necessary to prevent urethral erosion and device infection.
人工尿道括约肌（AUS）植入术是欧洲泌尿外科学会和美国泌尿外科学会指南推荐的用于治疗因固有括约肌缺陷导致的压力性尿失禁的标准治疗方法。此前已有关于在新膀胱构建或尿道成形术后植入AUS的报道；然而，关于同时接受这两种手术的患者的报道却很少。本报告介绍了一例独特的病例，该患者在接受尿道成形术和回肠新膀胱构建术后接受了人工尿道括约肌（AUS）植入。
一名76岁男性，有尿道狭窄和回肠新膀胱构建病史，因持续性压力性尿失禁转诊至我科。在左下腹放置了一个压力调节球囊，此处腹膜保持完整。术后约7周激活AUS，恢复了尿控。除了标准的使用说明外，还建议患者定时排尿，并在夜间及发热时停用AUS。尿失禁明显改善，术后一年效果得以维持，无并发症。器械感染和尿道糜烂是AUS植入过程中应考虑的关键并发症。我们关注AUS植入部位及围手术期感染控制以解决这一问题。
在接受尿道成形术和回肠新膀胱构建术的患者中进行了AUS植入。我们认为围手术期及术后采取细致的措施对于预防尿道糜烂和器械感染是必要的。
