Michael N Ferrandino, Gustavo Espino, Marcos Young, Elías Bodden, Jeffrey C Gahan
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引用次数: 0
摘要
导言:压力性尿失禁(SUI)是前列腺癌机器人辅助根治性前列腺切除术(RARP)后常见的并发症。RARP术后尿道缩短和尿道支撑力减弱是导致尿失禁的因素:在此,我们介绍一种使用新型可吸收泌尿系统支架的手术方法,以减轻正在进行的单臂前瞻性研究中两名患者的 SUI。该支架旨在通过延长 RARP 后的有效尿道来减轻尿道括约肌的负担。支架放置在吻合部位,在前列腺切除术后和吻合术前覆盖膀胱颈和尿道残端。两名患者都成功接受了前列腺切除术和泌尿系统支架置入术,未报告围手术期并发症。根据术后1个月和3个月的尿垫重量和使用情况,两名患者在RARP术后均未出现早期尿失禁:结论:可吸收尿道支架的早期使用经验表明,它可以安全有效地预防 RARP 术后的 SUI。正在进行的该设备前瞻性研究得出的早期和长期结果将更好地确定其在预防 SUI 方面的潜在作用。
Initial Experience with an Absorbable Urologic Scaffold to Mitigate Early Urinary Incontinence following Radical Prostatectomy: A Report of 2 Cases.
Introduction: Stress urinary incontinence (SUI) is a frequent, known complication following robot-assisted radical prostatectomy (RARP) for prostate cancer. Urethral shortening and reduced urethral support following RARP are contributing factors.
Case presentations: Herein, we describe a surgical approach using a novel absorbable urologic scaffold to mitigate SUI in 2 patients enrolled in an ongoing single-arm prospective study. The scaffold is designed to relieve the burden on the urinary sphincter by lengthening the effective urethra following RARP. The scaffold is placed at the anastomotic site, overlying the bladder neck and urethral stump following prostate removal and prior to the creation of the anastomosis. Both patients successfully underwent the prostatectomy and urologic scaffold placement with no reported perioperative complications. Neither patient suffered from early SUI following RARP as measured by pad weight and usage at 1 and 3 months following the procedure.
Conclusion: Early experience with the absorbable urologic scaffold suggests it could safely and effectively prevent SUI following RARP. Early and long-term results derived from the ongoing prospective study with this device will better define its potential role in the prevention of SUI.
期刊介绍:
Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.