摘要
BACKGROUND Artificial urethral sphincter(AUS)implantation is currently the gold standard for treating moderate and severe urinary incontinence.Currently,cuffs are chosen based on the surgeon’s experience,and adjusting cuff tightness is crucial.The TDOC air-charged catheter has not been proven to be inferior to traditional catheters.We report how intraoperative urethral pressure profilometry is performed using a T-DOC air-charged catheter with ambulatory urodynamic equipment,to guide cuff selection and adjustment.CASE SUMMARY A 67-year-old man presented to our hospital with complete urinary incontinence following transurethral prostatectomy,using five pads/d to maintain local dryness.Preoperatively,the maximum urethral pressure(MUP)and maximum urethral closure pressure(MUCP)were 52 cmH2O and 17 cmH2O,respectively.An AUS was implanted.Intraoperatively,in the inactivated state,the MUP and MUCP were 53 cmH2O and 50 cmH2O,respectively;in the activated state,they were 112 cmH2O and 109 cmH2O,respectively.The pump was activated 6 wk postoperatively.Re-measurement of the urethral pressure on the same day showed that in the inactivated state,MUP and MUCP were 89 cmH2O and 51 cmH2O,respectively,and in the activated state,120 cmH2O and 92 cmH2O,respectively.One month after device activation,telephonic follow-up revealed that pad use had decreased from five pads/d to one pad/d,which met the standard for social continence(0-1 pad per day).There were no complications.CONCLUSION The relationship between intraoperative urethral pressure and urinary continence post-surgery can provide data for standardizing AUS implantation and evaluating efficacy.
BACKGROUND Artificial urethral sphincter（AUS） implantation is currently the gold standard for treating moderate and severe urinary incontinence. Currently, cuffs are chosen based on the surgeon’s experience, and adjusting cuff tightness is crucial. The TDOC air-charged catheter has not been proven to be inferior to traditional catheters. We report how intraoperative urethral pressure profilometry is performed using a T-DOC air-charged catheter with ambulatory urodynamic equipment, to guide cuff selection and adjustment.CASE SUMMARY A 67-year-old man presented to our hospital with complete urinary incontinence following transurethral prostatectomy, using five pads/d to maintain local dryness. Preoperatively, the maximum urethral pressure（MUP） and maximum urethral closure pressure（MUCP） were 52 cm H2O and 17 cm H2O , respectively.An AUS was implanted. Intraoperatively, in the inactivated state, the MUP and MUCP were 53 cm H2O and 50 cm H2O , respectively; in the activated state, they were 112 cm H2O and 109 cm H2O, respectively. The pump was activated 6 wk postoperatively. Re-measurement of the urethral pressure on the same day showed that in the inactivated state, MUP and MUCP were 89 cm H2O and 51 cm H2O , respectively, and in the activated state, 120 cm H2O and 92 cm H2O,respectively. One month after device activation, telephonic follow-up revealed that pad use had decreased from five pads/d to one pad/d, which met the standard for social continence（0-1 pad per day）. There were no complications.CONCLUSION The relationship between intraoperative urethral pressure and urinary continence post-surgery can provide data for standardizing AUS implantation and evaluating efficacy.
基金
National Key R and D Program of China,No.2018YFC2002202
