The "Minimal-Touch" Technique for Artificial Urinary Sphincter Placement: Description and Outcomes.

IF 1 Q4 UROLOGY & NEPHROLOGY
Matthew J Ziegelmann, Kevin J Hebert, Brian J Linder, Laureano J Rangel, Daniel S Elliott
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Abstract

Objective: The study aimed to describe "minimal-touch" technique for primary artificial urinary sphincter placement and evaluate early device outcomes by comparing it with a historical cohort.

Materials and methods: We identified patients who underwent primary artificial urinary sphincter placement at our institution from 1983 to 2020. Statistical analysis was performed to identify the rate of postoperative device infection in patients who underwent minimal touch versus those who underwent our traditional technique.

Results: 526/2601 total procedures (20%) were performed using our "minimal-touch" approach, including 271/1554 patients (17%) who underwent primary artificial urinary sphincter placement over the study period. Around 2.3% of patients experienced device infection after artificial urinary sphincter procedures. In the "minimal-touch" era, 3/526 patients (0.7%) experienced device infection, including 1/271 (0.4%) of those with primary artificial urinary sphincter placement. In comparison, 46/2075 patients (2.7%) experienced device infection using the historical approach, with 29/1283 (2.3%) of primary artificial urinary sphincter placements resulting in removal for infection. Notably, 90% of device infections occurred within the first 6 months after primary placement. The difference in cumulative incidence of device infections at 12 months did not meet our threshold for statistical significance for either the total cohort of all AUS procedures (primary and revision) or the sub-group of only those patients undergoing primary artificial urinary sphincter placement (Gray K-sample test; P=.13 and .21, respectively).

Conclusion: The "minimal-touch" approach for artificial urinary sphincter placement represents an easy-to-implement modification with potential implications on device outcomes. While early results appear promising, longer-term follow-up with greater statistical power is needed to determine whether this approach will lower the infection risk.

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人工尿道括约肌放置的“最小触摸”技术:描述和结果
目的:本研究旨在描述原发性人工尿道括约肌放置的“最小接触”技术,并通过与历史队列的比较来评估早期装置的结果。材料和方法:我们确定了1983年至2020年在我们机构接受原发性人工尿道括约肌置入术的患者。进行统计分析,以确定接受最小接触的患者与接受我们传统技术的患者的术后器械感染率。结果:使用我们的“最小接触”方法共进行了526/2601次手术(20%),其中271/1554名患者(17%)在研究期间接受了初次人工尿道括约肌置入术。大约2.3%的患者在人工尿道括约肌手术后出现装置感染。在“最小接触”时代,3/526名患者(0.7%)经历了装置感染,其中1/271名患者(0.4%)接受了原发性人工尿道括约肌置入术。相比之下,使用历史方法的46/2075名患者(2.7%)经历了装置感染,其中29/1283名(2.3%)的原发性人工尿道括约肌植入术因感染而被切除。值得注意的是,90%的装置感染发生在初次植入后的前6个月内。12个月时装置感染累积发生率的差异不符合我们对所有AUS手术(初次和翻修)的总队列或仅接受初次人工尿道括约肌置入术的患者亚组的统计显著性阈值(Gray K-sample检验;P = .分别为.13和.21)。结论:人工尿道括约肌放置的“最小接触”方法是一种易于实施的改良方法,对装置的效果有潜在影响。虽然早期结果看起来很有希望,但需要更具统计能力的长期随访来确定这种方法是否会降低感染风险。
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
Turkish journal of urology
Turkish journal of urology Medicine-Urology
CiteScore
2.10
自引率
0.00%
发文量
53
期刊介绍: The aim of the Turkish Journal of Urology is to contribute to the literature by publishing scientifically high-quality research articles as well as reviews, editorials, letters to the editor and case reports. The journal’s target audience includes, urology specialists, medical specialty fellows and other specialists and practitioners who are interested in the field of urology.
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