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首页> 外文期刊>The Journal of Urology >Combined inflatable penile prosthesis-artificial urinary sphincter implantation: No increased risk of adverse events compared to single or staged device implantation
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Combined inflatable penile prosthesis-artificial urinary sphincter implantation: No increased risk of adverse events compared to single or staged device implantation

机译：阴茎假体-人工尿道括约肌联合充气：与单次或分阶段器械植入相比，不良事件发生的风险没有增加

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Purpose: Little data exist on the outcome of combined inflatable penile prosthesis and artificial urinary sphincter insertion for erectile dysfunction and stress urinary incontinence. We assessed patient outcomes for combined vs single device implantation at a single institution. Materials and Methods: We retrospectively reviewed the records of all patients who underwent inflatable penile prosthesis and artificial urinary sphincter insertion at our hospital from January 2000 to December 2011. A total of 55 combined procedures were performed compared to the single insertion of 336 inflatable penile prostheses and 279 artificial urinary sphincters. Results: The surgical approach consisted of penoscrotal incisions for inflatable penile prostheses and transperineal incisions for artificial urinary sphincter cuff placement with a secondary lower abdominal incision for reservoir placement. Men treated with combined implantation had greater mean age and were at greater risk for prostate cancer diagnosis and treatment, and at lesser risk for Peyronie disease than men who received an inflatable penile prosthesis alone (each p<0.05). Although operative time was significantly longer for the combined procedure than for the inflatable penile prosthesis alone and the AUS alone (mean 218.1 vs 145.9 and 114.7 minutes, respectively, p <0.0001), the rate of device infection, erosion or malfunction was not increased irrespective of combined or staged procedures (p >0.05). Conclusions: Combined inflatable penile prosthesis-artificial urinary sphincter implantation and staged prosthesis implantation are feasible without an increased risk of adverse outcomes compared to implantation of a single prosthesis. Patients with concomitant erectile dysfunction and stress urinary incontinence should be counseled about the possible advantages of this surgical option, which include a single anesthesia event and faster resumption of sexual activity and urinary control.
机译：目的：关于可膨胀的阴茎假体和人工尿道括约肌插入术治疗勃起功能障碍和压力性尿失禁的结果很少。我们评估了在单个机构进行联合或单装置植入的患者预后。资料与方法：我们回顾性分析了我院自2000年1月至2011年12月接受阴茎假体充气和人工尿道括约肌插入术的所有患者的记录。与单次插入336例阴茎充气假体相比，总共进行了55例联合手术。和279个人工尿道括约肌。结果：手术方法包括阴囊切口用于充气阴茎假体，以及会阴切口用于人工尿道括约肌袖套的放置，而次级下腹部切口用于储液器的放置。与仅接受可充气阴茎假体的男性相比，接受联合植入治疗的男性平均年龄更大，前列腺癌的诊断和治疗风险更高，而佩罗尼氏病的风险更低（每个P <0.05）。尽管联合手术的手术时间比单独使用充气式阴茎假体和单独使用AUS的手术时间明显更长（分别为218.1、145.9和114.7分钟，p <0.0001），但无论如何，器械感染，糜烂或功能障碍的发生率均未增加联合或分阶段手术的比例（p> 0.05）。结论：与单个假体相比，可膨胀的阴茎假体-人工尿道括约肌联合分期植入假体是可行的，并且不会增加不良后果的风险。应建议伴有勃起功能障碍和压力性尿失禁的患者选择这种手术方法可能带来的好处，包括单次麻醉，更快恢复性活动和控制尿液。

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