Koutani A, Lechevallier E, Coulange C
Service d'Urologie et de Transplantation Rénale, Hôpital Salvator, Marseille.
Ann Urol (Paris). 1997;31(6-7):382-5.
To present the results of a series of artificial sphincters implanted for urinary incontinence after prostatic surgery.
From 1987 to 1996, artificial sphincters were implanted for urinary incontinence after prostatic surgery, consisting of one transvesical prostatectomy, 11 prostatic resections and 4 radical prostatectomies. All these patients were evaluate by urine culture, cystourethrography and urethrocystoscopy. Eleven patients underwent urodynamic assessment. The AMS 800 artificial sphincter was used.
The mean interval between onset of incontinence and implantation was 18 months. The mean follow-up after implantation of the sphincter was 6 years. An operative wound of the bulbar urethra did not prevent implantation of the sphincter, but required repair and prolonged catheterization (12 days). The mean duration of catheterization was 6 days. The overall functional result was 81% (13 case), and 75% of sphincters were functional at 5 years. Five revisions were necessary to maintain functioning of the sphincter in 2 cases of rupture and 1 displacement of the balloon, 1 case of urethral atrophy and 1 rupture of the pump. Three explanations, 2 total and 1 partial, were performed. Two reimplantations were performed after 12 months and 26 months respectively.
The AMS 800 artificial sphincter currently represents an effective treatment for urinary incontinence due to sphincter insufficiency after prostatic surgery. However, an old artificial sphincter may require revision to restore function.
介绍一系列为前列腺手术后尿失禁植入人工括约肌的结果。
1987年至1996年，为前列腺手术后尿失禁植入人工括约肌，其中包括1例经膀胱前列腺切除术、11例前列腺切除术和4例根治性前列腺切除术。所有这些患者均通过尿培养、膀胱尿道造影和尿道膀胱镜检查进行评估。11例患者接受了尿动力学评估。使用的是AMS 800人工括约肌。
尿失禁发作与植入之间的平均间隔为18个月。括约肌植入后的平均随访时间为6年。球部尿道的手术伤口并不妨碍括约肌的植入，但需要修复并延长导尿时间（12天）。平均导尿时间为6天。总体功能结果为81%（13例），5年后75%的括约肌仍有功能。2例球囊破裂和1例移位、1例尿道萎缩和1例泵破裂的患者需要进行5次修复以维持括约肌功能。进行了3次解释，2次完全解释和1次部分解释。分别在12个月和26个月后进行了2次重新植入。
目前，AMS 800人工括约肌是治疗前列腺手术后因括约肌功能不全导致尿失禁的有效方法。然而，旧的人工括约肌可能需要进行修复以恢复功能。
