Difficulties in Manipulating the Female Artificial Urinary Sphincter Pump: Prevalence and Management.

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Neurourology Journal Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI:10.5213/inj.2448372.186

Alexandre Dubois, Valentine Lethuillier, Claire Richard, Camille Haudebert, Juan Penafiel, Caroline Voiry, Magali Jezequel, Emmanuelle Emmanuel, Ouis-Paul Berthelot, Lucas Freton, Juliette Hascoet, Andrea Manunta, Benoit Peyronnet

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引用次数: 0

Abstract

Purpose: While pump manipulation is rarely problematic in male patients with artificial urinary sphincters (AUSs), the situation may differ in female patients due to anatomical or cultural factors. This study aimed to evaluate the prevalence of difficulties in pump manipulation among female AUS patients, identify associated risk factors, and explore management strategies for this challenging issue.

Methods: Data were collected from all female patients who underwent a robotic AUS implantation at a single academic center between 2014 and 2022. The primary endpoint was temporary difficulties, defined by at least one other short hospitalization to learn pump manipulation.

Results: Out of the 88 female AUS patients included in the study, 20 experienced initial difficulties manipulating the pump, accounting for 22.7% of the group. Temporary difficulties were reported by 16 patients (18.2%), while 4 patients (4.5%) had their devices permanently deactivated. Surgical reoperations to reposition the pump were necessary for 5 patients, representing 5.6% of the sample. The only variables significantly associated with temporary difficulties were longer operative time (183.4 minutes vs. 159.1 minutes, P=0.04) and the overall experience of the center (32 vs. 50, P=0.04). The sole variable significantly linked to serious difficulties was the overall experience of the center (11 vs. 47, P=0.004). Although the median age and body mass index were higher in the group with temporary difficulties, these differences were not statistically significant.

Conclusion: Difficulties in manipulating the pump are relatively common among female AUS patients. Most of these difficulties can be resolved through repeated patient education and careful follow-up. However, some may lead to serious complications. Raising awareness of this issue, along with ongoing patient education and meticulous follow-up, may help to minimize these consequences.

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操纵女性人工尿括约肌泵的困难：患病率和处理。

目的：虽然男性人工尿括约肌（AUSs）患者的泵操作很少有问题，但由于解剖学或文化因素，女性患者的情况可能有所不同。本研究旨在评估女性AUS患者泵操作困难的普遍程度，确定相关的危险因素，并探讨这一具有挑战性问题的管理策略。方法：收集2014年至2022年间在同一学术中心接受机器人AUS植入的所有女性患者的数据。主要终点是暂时性困难，定义为至少一次其他短期住院学习泵操作。结果：在纳入研究的88例女性AUS患者中，20例患者在初始操作泵时遇到困难，占该组的22.7%。16例患者（18.2%）报告了暂时性困难，而4例患者（4.5%）永久停用了他们的设备。5例患者需要再次手术重新定位泵，占样本的5.6%。唯一与暂时性困难显著相关的变量是较长的手术时间（183.4分钟对159.1分钟，P=0.04）和中心的整体经验（32分钟对50分钟，P=0.04）。与严重困难显著相关的唯一变量是中心的整体体验（11比47，P=0.004）。虽然暂时困难组的中位年龄和体重指数较高，但这些差异没有统计学意义。结论：女性AUS患者操作泵困难较为常见。这些困难大多可以通过反复的患者教育和仔细的随访来解决。然而，有些可能会导致严重的并发症。提高对这一问题的认识，以及持续的患者教育和细致的随访，可能有助于尽量减少这些后果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Neurourology Journal UROLOGY & NEPHROLOGY-

CiteScore

4.40

自引率

21.70%

发文量

审稿时长

4 weeks

期刊介绍： The International Neurourology Journal (Int Neurourol J, INJ) is a quarterly international journal that publishes high-quality research papers that provide the most significant and promising achievements in the fields of clinical neurourology and fundamental science. Specifically, fundamental science includes the most influential research papers from all fields of science and technology, revolutionizing what physicians and researchers practicing the art of neurourology worldwide know. Thus, we welcome valuable basic research articles to introduce cutting-edge translational research of fundamental sciences to clinical neurourology. In the editorials, urologists will present their perspectives on these articles. The original mission statement of the INJ was published on October 12, 1997. INJ provides authors a fast review of their work and makes a decision in an average of three to four weeks of receiving submissions. If accepted, articles are posted online in fully citable form. Supplementary issues will be published interim to quarterlies, as necessary, to fully allow berth to accept and publish relevant articles.