Determinants and prognostic value of post-operative maximum urethral closure pressure after artificial urinary sphincter in men
Determinants and prognostic value of post-operative maximum urethral closure pressure after artificial urinary sphincter in men
复制标题
男性人工尿道括约肌术后最大尿道闭合压的决定因素和预后价值
DOI：
10.1007/s00345-019-02884-7
复制
发表时间：
2019
影响因子：
3.4
通讯作者：
B. Peyronnet
中科院分区：
文献类型：
--
作者：
I. Bentellis;M. El;J. Hascoet;Q. Alimi;R. Mathieu;S. Vincendeau;J. Kerdraon;C. Voiry;A. Manunta;B. Peyronnet
目的评价男性患者AUS植入术后最大尿道闭合压（MUCP）的决定因素和预后价值。方法对单中心2008年至2018年期间所有接受AUS植入的男性患者进行回顾性分析，进行探索性研究。作为研究期间日常实践的一部分，系统地进行了术后尿道轮廓测量，以评估 AUS 连续闭合（c-MUCP）和打开（o-MUCP）的术后 MUCP。计算 c-MUCP 与由压力调节球囊 (PRB) 确定的制造商理论压力目标之间的差异 (diff-th-MUCP)。主要终点是 3 个月时的社交节制，定义为每天 0-1 次保护。结果纳入了 90 名患者。中位年龄为 71 岁，中位随访时间为 50 个月。 84%的患者失禁的病因是根治性前列腺切除术，6.6%的患者是内窥镜前列腺手术。 74.4% 的患者在 3 个月时能够社交自制。大陆组的 c-MCUP 显着较高（53 [42.2, 60.2] vs 62 [58, 70]p= 0.02）。两组之间的 diff-th-MUCP 没有显着差异（18 [0, 23] vs 1 [− 2, 7.7]p= 0.29）。 c-MUCP 与翻修和/或拔除风险没有统计相关性。 结论 男性患者 AUS 植入后的 MUCP 通常与制造商的压力目标不同。术后 c-MUCP 可能与功能结果显着相关，表明它可能是治疗决策的宝贵工具。这应该通过更大规模的研究来证实。
PurposeTo evaluate the determinants and prognostic value of post-operative maximum urethral closure pressure (MUCP) after AUS implantation in male patients.MethodsThe charts of all male patients who had an AUS implantation between 2008 and 2018 at a single center were reviewed retrospectively for an exploratory study. A post-operative urethral profilometry was performed systematically as part of routine daily practice over the study period to assess the post-operative MUCP with the AUS consecutively closed (c-MUCP) and opened (o-MUCP). The difference between c-MUCP and the manufacturer’s theoretical pressure objective determined by the pressure regulating balloon (PRB) was calculated (diff-th-MUCP). The primary endpoint was social continence at 3 months defined as 0–1 protection/day.ResultsNinety patients were included. The median age was 71 years, and the median follow-up was 50 months. The etiology of incontinence was radical prostatectomy in 84% of cases, and endoscopic prostate surgery in 6.6% of patients. There were 74.4% of patients who were socially continent at 3 months. The c-MCUP was significantly higher in the continent group (53 [42.2, 60.2] vs 62 [58, 70]p= 0.02). The diff-th-MUCP did not differ significantly between the two groups (18 [0, 23] vs 1 [− 2, 7.7]p= 0.29). The c-MUCP was not statistically associated with the risk of revision and/or explantation.ConclusionThe MUCP after AUS implantation in male patients often differs from the manufacturer’s pressure objective. The postoperative c-MUCP might be significantly associated with functional outcomes suggesting that it might be a valuable tool for treatment decision-making. This should be confirmed by larger studies.