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首页> 外文期刊>BJU international >The outcome of artificial urinary sphincter placement after a mean 15-year follow-up in a paediatric population.
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The outcome of artificial urinary sphincter placement after a mean 15-year follow-up in a paediatric population.

机译：小儿人群平均15年随访后人工尿道括约肌置入的结果。

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OBJECTIVE: To evaluate the long-term outcome in children who had an artificial urinary sphincter (AUS) placed, after a minimum of 10 years of follow-up. PATIENTS AND METHODS: The medical records of patients who had an AUS placed at the Children's Hospital of Michigan were reviewed and a telephone questionnaire was then completed by all patients with an AUS currently in place. RESULTS: Forty-seven children initially had an AUS placed between October 1978 and August 1986; medical records and follow-up were available for 32. After a mean follow-up of 15.4 years, 13 patients had had the AUS removed and 19 currently have an intact AUS. Erosion or infection was responsible for all AUS removals. Possible risk factors for AUS removal were prior AUS erosion, prior bladder neck surgery and a balloon pressure of >70 cmH2O. Eighteen of 19 patients with an intact AUS are dry and seven void volitionally. Revision was the most common reason for additional surgery, but the revision rate has decreased with the most current AS-800 model, to 0.03 revisions per patient-year. Of the 13 patients with an AS-800 model placed after 1987, nine have not required revision. Upper tract changes were mild and uncommon. CONCLUSION: The AUS is a durable and effective surgical option in the management of neurogenic urinary incontinence, and is the only reliable technique that can preserve volitional voiding. With technical improvements to the AUS and a longer follow-up, the revision rate has decreased. Causes of AUS removal may be preventable with improvements in surgical technique and patient selection. AUS placement should be considered as a first choice for the surgical management of neurogenic sphincteric incompetence.
机译：目的：评估经过至少10年的随访后，放置了人工尿道括约肌（AUS）的儿童的长期结局。患者和方法：对密歇根州儿童医院放置AUS的患者的病历进行了审查，然后对所有已使用AUS的患者填写了电话问卷。结果：1978年10月至1986年8月，最初有47名儿童接受了AUS治疗。共有32位患者接受了病历和随访。平均随访15.4年后，有13例患者切除了AUS，目前有19例患者保留了完整的AUS。侵蚀或感染是所有AUS清除的原因。去除AUS的可能危险因素是先前的AUS侵蚀，先前的膀胱颈手术和球囊压力> 70 cmH2O。 AUS完整的19例患者中有18例干燥，自愿丧失7例。修订是进行额外手术的最常见原因，但是对于最新的AS-800型号，修订率已经降低，降至每患者年0.03修订。在1987年以后放置的13例AS-800模型患者中，有9例不需要进行修订。上道变化轻微且不常见。结论：AUS是治疗神经性尿失禁的一种持久而有效的手术选择，并且是唯一可以保留自愿性排尿的可靠技术。随着对AUS的技术改进和更长的随访时间，修订率降低了。随着手术技术和患者选择的改善，可以避免AUS切除的原因。 AUS放置应被视为神经源性括约肌功能不全的外科手术治疗的首选。

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