AdVance经闭孔吊带治疗男性中、重度压力性尿失禁的疗效

Short-term outcome of transobturator sling suspension system AdVance in the treatment of men with moderate to severe stress urinary incontinence

目的:评估男性根治性前列腺切除术后压力性尿失禁(stress urinary incontinence,SUI)患者采用AdVance经闭孔吊带术治疗的早期疗效。方法:2名根治性前列腺切除术后SUI患者纳入本研究,尿失禁程度通过体格检查和尿垫使用量来评定,患者的生活质量在术后1个月和6个月的回访时获得。结果:中度SUI患者术前国际前列腺症状评分表(international prostate scoring system,IPSS)的生活质量评分为6分,术后IPSS生活质量评分2分。最大尿流率20 mL/s,残余尿量0 mL。患者整个随访期间临床表现稳定,没有随着时间推移加重。术后未发现伤口感染,尿道没有侵蚀,患者对手术效果感受为满意。重度SUI患者术后每天使用7～8块尿垫(术前使用8～10块尿垫),尿垫使用量较术前稍减少。排尿日记显示,日间自主排尿2～3次,其余均需要尿垫。术前IPSS生活质量评分6分,术后IPSS生活质量评分5分。最大尿流率15 mL/s,残余尿量0 mL。术后未发现伤口感染,尿道没有侵蚀,患者对手术的满意度为不满意。结论:AdVance经闭孔吊带术是治疗前列腺切除术后尿失禁的一个有效、安全的治疗方法,尤其适用于轻度或中度SUI患者。

Objective： To evaluate the clinical outcome after the placement of AdVance sling in men with stress urinary incontinence （SUI） after radical prostatectomy. Methods： In this study, 2 SUI cases secondary to radical prostatectomy were recruited. Incontinence was assessed on basis of the physical exam and number of pad usage. The patients＇ quality of life was evaluated using Patient Perception of Bladder Condition at the end of 1 month and 6 months post-operatively. Results： The moderate SUI patient （ case 1 ） usually used 1 to 2 urinary pads per day, 6 months postoperatively, with 4 to 5 pads preoperatively. The pad usage was significantly reduced after surgery, and obvious improvement was seen in urinary incontinence. Voiding diary showed the voiding number was 7 to 8 per day, 2 to 3 per night and leakage of urine 2 to 3 times. The IPSS QOL score was 6 preoperatively and dropped to 2 after surgery. The maximum urinary flow rate was 20 mL/s with no residual urine. No wound infection and urethral erosion were found postoperatively. The patient was satisfied with the result of the surgery. The severe SUI patient （case 2） used 7 to 8 pads per day, 6 months postoperatively, with 8 to 10 pads preoperatively. The pad usage was mildly reduced after surgery. Voiding diary showed only 2 to 3 times self-voiding, and the rest needed pads. The IPSS QOL score was 6 preoperatively and 5 postoperatively. The maximum uri- nary flow rate was 15 mL/s with no residual urine. No wound infection and urethral erosion were found postoperatively. The patient was unsatisfied with the result of the surgery. Conclusion： Placement of the AdVance sling represents an effective and safe treatment option for patients with post radical prostatectomy incontinence, especially for those with moderate or mild SUI.