Is artificial urinary sphincter surgery safe and effective in elderly males aged 70 years and above?

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY LUTS: Lower Urinary Tract Symptoms Pub Date : 2022-08-24 DOI:10.1111/luts.12460

Eric Chung, Juan Wang, Ross Cartmill

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引用次数: 1

Abstract

Objectives

To evaluate the clinical outcomes and patient satisfaction rate between men aged under and over 70 years who underwent artificial urinary sphincter (AUS) surgery.

Methods

A prospective review of all men who received AUS between January 2008 and January 2018 was undertaken with a minimum 24-month review. All patient demographics and surgical outcomes including data on the Incontinence Impact Questionnaire, Patient Global Impression of Improvement (PGI-I) and National Surgical Quality Improvement Program Frailty Index (NSQIP-FI) scores, as well as patient satisfaction rates, were recorded.

Results

Of the 245 AUS implanted, 60 patients were aged ≥70 years with 45 virgin cases and 15 revision AUS. Reduction in mean pad use and weight over 24 hours were significant at 0.21 (0–1) pads and 8 (0–30) g in both groups with no significant difference (P = 0.76). Kaplan–Meier estimates of AUS survival showed no significant difference between men aged ≥ and <70 years at 1 year (98% versus 96%; P = 0.44). The multivariate logistic regression model showed that radiation (adjusted odds ratio [OR] 3.8, 95% CI 1.4–6.8; P < 0.01) was a significant predictor of AUS revision, while age ≥ 70 years (adjusted OR 1.0, 95% CI 0.8–8.8; P = 0.14) and frailty (NSQIP-FI ≥ 0.27 adjusted OR 0.9, 95% CI 0.2–7.6; P = 0.82) were not. There were no significant differences in PGI-I scores (P = 0.43) and overall satisfaction rate (83% versus 84%; P = 0.44) between the two groups.

Conclusions

Men aged ≥70 years reported similar clinical efficacy as men aged <70 years in terms of device survival and satisfaction rates following AUS surgery.

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人工尿括约肌手术对70岁及以上的老年男性安全有效吗?

目的评价70岁以下和70岁以上男性行人工尿括约肌(AUS)手术的临床疗效和患者满意度。方法对2008年1月至2018年1月期间接受AUS治疗的所有男性进行前瞻性评估，至少进行24个月的评估。记录所有患者人口统计数据和手术结果，包括失禁影响问卷、患者总体改善印象(PGI-I)和国家手术质量改进计划脆弱指数(NSQIP-FI)评分以及患者满意度。结果245例植入AUS, 60例年龄≥70岁，其中45例为首次植入，15例为翻修AUS。在24小时内，两组患者在0.21(0-1)个垫子和8 (0-30)g时，平均垫子使用量和体重均显著减少，差异无统计学意义(P = 0.76)。Kaplan-Meier估计，≥70岁和≥70岁男性的1年生存率无显著差异(98% vs 96%;p = 0.44)。多因素logistic回归模型显示辐射(校正优势比[OR] 3.8, 95% CI 1.4-6.8;P < 0.01)是AUS修订的重要预测因子，而年龄≥70岁(调整OR 1.0, 95% CI 0.8-8.8;P = 0.14)和虚弱(NSQIP-FI≥0.27调整OR 0.9, 95% CI 0.2-7.6;P = 0.82)。PGI-I评分(P = 0.43)和总体满意度(83%对84%;P = 0.44)。结论≥70岁男性与≥70岁男性在AUS手术后的器械存活率和满意率方面的临床疗效相似。

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

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.