人工尿道括约肌治疗括约肌功能不全所致尿失禁
[Artificial urinary sphincter in the treatment of urinary incontinence caused by sphincter insufficiency].
作者信息
Castro Díaz D, Ravina Pisaca M, Díaz García J L, Concepción Masip T, Rodríguez Hernández P, Bañares Baudet F
机构信息
Servicio de Urología, Hospital Universitario de Canarias. Tenerife, España.
出版信息
Arch Esp Urol. 1997 Jul-Aug;50(6):595-601.
OBJECTIVE
To evaluate the results relative to continence and the complications of the artificial urinary sphincter in the treatment of urinary incontinence due to sphincter incompetence.
METHODS
The artificial urinary sphincter model AS 800 was implanted in 35 patients with incontinence arising from various causes. Follow-up ranged from 14 to 108 months (mean 39.8). Patients ages ranged from 4 to 68 years (mean 44.4). There were 17 female (49%) and 18 male patients (51%). The cuff was implanted around the bladder neck in 25 patients (71%) and around the bulbous urethra in 10 (29%).
RESULTS
There were 2 mechanical device failures, 2 pump erosion and 1 tube erosion through the abdominal wall in a patient who had had a perforation of an augmentation cystoplasty. Thirty-one patients (88%) became continent. Ten patients (28%) had another operation for device revision or relapse.
CONCLUSION
The artificial urinary sphincter is a valid alternative in the treatment of urinary incontinence due to sphincteric incompetence. It is possible to achieve good continence rates, although there is a high revision rate and lifetime follow-up is required.
目的
评估人工尿道括约肌治疗括约肌功能不全所致尿失禁的控尿效果及并发症。
方法
对35例因各种原因导致尿失禁的患者植入AS 800型人工尿道括约肌。随访时间为14至108个月（平均39.8个月）。患者年龄为4至68岁（平均44.4岁）。其中女性17例（49%），男性18例（51%）。25例（71%）患者的袖带植入膀胱颈周围，10例（29%）植入球部尿道周围。
结果
发生2例机械装置故障、2例泵腐蚀，1例曾行膀胱扩大成形术穿孔的患者出现经腹壁的导管腐蚀。31例（88%）患者实现控尿。10例（28%）患者因装置翻修或复发再次手术。
结论
人工尿道括约肌是治疗括约肌功能不全所致尿失禁的有效替代方法。尽管翻修率高且需要终身随访，但仍可获得良好的控尿率。
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