经闭孔盆底网片球部尿道悬吊术治疗前列腺切除术后尿失禁的中长期疗效分析  

Medium and long-term efficacy with transobturator bulbourethral suspension with Pelvic sling for the treatment of post-prostatectomy incontinence

作　　者：丁留成[1] 黄懿[1] 舒乐 张思聪[1] 陈正森 沈百欣[1] 薛珺[1] 韶云鹏 顾民 卫中庆[1] DING Liucheng;HUANG Yi;SHU Le;ZHANG Sicong;CHEN Zhengsen;SHEN Baixin;XUE Jun;SHAO Yunpeng;GU Min;WEI Zhongqing(Department of Urology,Second Affiliated Hospital of Nanjing Medical University,Nanjing,210011,China)

机构地区：[1]南京医科大学第二附属医院泌尿外科,南京210011

出　　处：《临床泌尿外科杂志》2022年第8期587-590,共4页Journal of Clinical Urology

基　　金：南医大二附院789人才基金资助(2020年);国家重点研发计划主动健康和老龄化科技应对重点专项(No:2018YFC202204)。

摘　　要：目的评估经闭孔盆底网片球部尿道悬吊术治疗男性前列腺切除术后尿失禁(post-prostatectomy incontinence,PPI)的中长期疗效。方法回顾性分析2018年4月—2020年4月南京医科大学第二附属医院12例PPI患者(9例前列腺癌根治术后,3例前列腺电切术后)采用经闭孔盆底网片球部尿道悬吊术的临床资料,并通过尿垫实验、国际尿失禁咨询问卷简表(ICIQ-SF)中长期随访以评估其疗效及安全性。结果本组患者中2例轻度尿失禁(24 h使用1~2个尿垫),7例中度尿失禁(24 h使用3~5个尿垫)和3例严重尿失禁(24 h使用超过5个尿垫);术前ICIQ-SF评分为(15.3±3.6)分,24 h尿垫数量为(5.4±2.3)个;术后3个月ICIQ-SF评分为(4.8±3.7)分,24 h尿垫数量为(1.8±0.4)个;术后12个月ICIQ-SF评分为(1.9±1.0)分,24 h尿垫数量为(1.2±0.4)个;术后24个月CIQ-SF评分为(1.4±1.2)分,24 h尿垫数量为(1.3±0.5)个。术后75%的患者不使用尿垫或只使用1~2个尿垫,未发现伤口感染、尿道侵蚀等并发症。结论经闭孔盆底网片球部尿道悬吊术是一个治疗前列腺切除术后尿失禁的患者安全有效的选择,但需要更长随访及精准适应证探索。Objective To assess the efficacy and safety of transobturator bulbourethral suspension with pelvic sling for the treatment of post-prostatectomy incontinence.Methods We retrospectively reviewed outcomes in patients who underwent transobturator bulbourethral suspension with pelvic sling for post-prostatectomy incontinence from April,2018 to April,2020 in Second Affiliated Hospital of Nanjing Medical University.Patients were evaluated continence symptoms using a 24-h pad test,the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF)at 3,12,and 24 months after surgery.Results Two patients had mild incontinence(1-2 pads/24 hours),seven patients had moderate urinary incontinence(3-5 pads/24 hours),and 3 patients had severe urinary incontinence(more than 5 pads/24 hours).The preoperative ICIQ-SF score was(15.3±3.6),and the number of 24-hour pad result was(5.4±2.3).The ICIQ-SF score was(4.8±3.7),and the number of 24-hour pad result was(1.8±0.4)after three months.The ICIQ-SF score was(1.9±1.0),and the number of the 24-hour pad result was(1.2±0.4)at 12 months.The ICIQ-SF score was(1.4±1.2).and the number of 24-hour pad result was(1.3±0.5)at 24 months after operation.Nine patients did not use pads or only 1-2 pads for 24 hours after surgery,and no complications such as wound infection or urethral erosion were found.Conclusion The transobturator bulbourethral suspension with pelvic sling is an effective option for the post-prostatectomy incontinence patient,but the long-term follow-up reports and suitable indication should be identified.

关 键 词：前列腺切除术后尿失禁 盆底网片 经闭孔球部尿道悬吊术 

分 类 号：R694[医药卫生—泌尿科学]