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首页> 外文期刊>European urology >Treatment of postprostatectomy male urinary incontinence with the transobturator retroluminal repositioning sling suspension: 3-year follow-up
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Treatment of postprostatectomy male urinary incontinence with the transobturator retroluminal repositioning sling suspension: 3-year follow-up

机译：经闭孔后腔复位吊带悬吊治疗前列腺切除术后男性尿失禁：3年随访

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Background: The AdVance male sling (American Medical Systems, Minnetonka, MN, USA) has been shown to be an efficacious device in short-term studies for postprostatectomy incontinence (PPI), but long-term studies are lacking. Objective: Examine the intermediate-term outcome with the AdVance sling for PPI management. Design, setting, and participants: A multicentre prospective evaluation was conducted on consecutive patients treated for PPI in three European tertiary reference centres. Intervention: Patients were implanted with the AdVance male sling with no associated surgery. Outcome measurements and statistical analysis: Measurements included daily pad usage, maximum flow rate (Q max), postvoid residual urine (PVR), the International Consultation on Incontinence Questionnaire-Short Form, the Incontinence Quality of Life questionnaires, and complications of surgery. Paired Wilcoxon signed rank test univariable and multivariable analyses were used. Results and limitations: Follow-up was available for 156 patients for the majority of parameters. Pad usage was significantly decreased compared with baseline at 12 mo and 3 yr (p 0.0001). At 12 mo, 76.9% of patients could be classified as cured or improved; this percentage was maintained at 3 yr (76.8%). Cure rates (58.6% vs 42.3%) and improvement rates (23.2% vs 25.0%) were higher in patients with mild or moderate incontinence compared with severe incontinence. Univariable analysis showed that pretreatment pad usage and severity of incontinence were both significant predictors of success (p = 0.0355 and p = 0.0420, respectively). However, in multivariable analysis, only pad usage was an independent predictor of success. There were no perioperative or severe postoperative complications. Most complications were Dindo grade I. Seven patients required a second treatment for stress urinary incontinence. There was no worsening over time. Limitations of this study included no comparator group, quality of life questionnaires in only two centres, and no 24-h pad test. Conclusions: The transobturator retroluminal repositioning sling suspension is effective and safe in the longer term for treating PPI.
机译：背景：AdvVance男性吊带（美国医疗系统，Minnetonka，MN，美国）在前列腺切除术后失禁（PPI）的短期研究中已被证明是一种有效的装置，但缺乏长期研究。目的：使用AdVance吊带检查PPI管理的中期结果。设计，设置和参与者：在三个欧洲三级参考中心对接受PPI治疗的连续患者进行了多中心前瞻性评估。干预：患者被植入AdVance男性吊带，没有相关手术。成果测量和统计分析：测量包括每日垫使用量，最大流量（Q max），无尿残留尿（PVR），失禁问卷调查表（简短形式）国际咨询，失禁生活质量问卷和手术并发症。使用配对的Wilcoxon符号秩检验进行单变量和多变量分析。结果与局限性：156例患者接受了大部分参数的随访。与基线相比，在12 mo和3年时，垫的使用率显着降低（p <0.0001）。在12个月时，可以将76.9％的患者归为治愈或好转;该百分比保持在3年（76.8％）。与轻度或中度尿失禁患者相比，轻度或中度尿失禁患者的治愈率（58.6％对42.3％）和改善率（23.2％对25.0％）更高。单变量分析表明，预处理垫的使用和大小便失禁都是成功的重要预测指标（分别为p = 0.0355和p = 0.0420）。但是，在多变量分析中，只有填充物的使用是成功的独立预测因素。没有围手术期或严重的术后并发症。大多数并发症为Dindo I级。七名患者因压力性尿失禁需要第二次治疗。随着时间的推移，并没有恶化。该研究的局限性包括没有比较者组，只有两个中心的生活质量调查表以及没有24小时便笺本测试。结论：经闭孔后腔复位后悬吊带长期治疗PPI是安全有效的。

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