机器人辅助人工尿括约肌翻修术治疗女性患者“非神经源性”压力性尿失禁:手术技术和结果。

IF 4.2 2区 医学 Q1 UROLOGY & NEPHROLOGY
Mariela Corrales, Paolo Geretto, Martina Moriconi, Maria L Gallo, Sabrina DE Cillis, Veronique Phé
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引用次数: 0

摘要

背景:机器人辅助人工尿括约肌(AUS)植入术是治疗女性严重应激性尿失禁(SUI)的合适选择。然而,据我们所知,在复发性SUI的情况下,任何机器人AUS翻修的报告都是可用的。本研究旨在提供一组在单一三级转诊中心接受机器人辅助AUS翻修的女性患者的结果,并描述手术技术。方法:主要手术步骤如下:通过机器人技术,通过连接管找到AUS储液器和尿道袖。然后取出储液器和激活泵,打开尿道袖带。使用卷尺测量膀胱颈的正确尺寸,并选择正确的袖带,然后将其放置。更换储层,并将连接管外化。最后,获得通往右大阴唇的皮下通道,并关闭连接。根据所述技术进行机器人AUS翻修的女性患者的回顾性队列结果也被提供。结果:纳入4例患者。中位年龄63岁(51 ~ 76岁);修订的中位时间为12年(5-16年)。中位手术时间为160.5(130 ~ 185分钟)。AUS修改的原因是所有情况下设备的机械故障。术中或术后未见严重并发症(Clavien-Dindo≥3)。4周AUS激活后,所有患者均干燥。结论:机器人AUS翻修术在女性患者中是一种可行且安全的技术,可以获得良好的功能预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Robot-assisted artificial urinary sphincter revision in "non-neurogenic" stress urinary incontinence in female patients: surgical technique and outcomes.

Background: Robot-assisted artificial urinary sphincter (AUS) implantation is a suitable option for the treatment of severe stress urinary incontinence (SUI) in female patients. However, to the best of our knowledge, any report of robotic AUS revision in case of recurrent SUI is available. The present study aims to provide the outcomes of a cohort of female patients subjected to robot-assisted AUS revision at a single tertiary referral center and to describe the surgical technique.

Methods: The main surgical steps are the following: through robotic technique, the AUS reservoir and urethral cuff are found by following the connection tubes. The reservoir and the activating pump are then removed, and the urethral cuff is opened. A measuring tape is used to obtain the correct size of the bladder neck and to choose the correct new cuff, which is then placed. The reservoir is replaced, and the connection tubes are exteriorized. Finally, a subcutaneous passage towards the right labia majora is obtained and the connections are closed. The outcomes of a retrospective cohort of female patients subjected to robotic AUS revision according to the described technique are also provided.

Results: Four patients were included. The median age was 63 (51-76 years); the median time to revision was 12 years (5-16 years). Median operative time was 160.5 (130-185 minutes). The reason for the AUS revision was a mechanical failure of the device in all cases. Any intra-operative or severe postoperative complication (Clavien-Dindo ≥3) was observed. After AUS activation at 4 weeks, all patients were dry.

Conclusions: Robotic AUS revision in female patients is a feasible and safe technique and can give excellent functional outcomes.

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来源期刊
Minerva Urology and Nephrology
Minerva Urology and Nephrology UROLOGY & NEPHROLOGY-
CiteScore
8.50
自引率
32.70%
发文量
237
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