Continence Reports最新文献_第3页

Effects of Glucagon like Peptide-1 agonists on patients with overactive bladder: A pilot study 胰高血糖素样肽-1激动剂对膀胱过动症患者的影响：一项初步研究

Continence Reports

Pub Date : 2025-05-13 DOI: 10.1016/j.contre.2025.100083

Max D. Sandler , Adam D. Williams , Alan Wein , Katherine Amin , Raveen Syan

Purpose:

To explore preliminary data on the subjective impact of Glucagon-Like Peptide-1 (GLP-1) agonists, commonly used for diabetes and obesity, on symptoms of overactive bladder (OAB), in order to guide future, larger-scale investigations.

Methods:

We distributed an anonymous survey on an online forum. Participants aged 18 or older who had used GLP-1 agonists and experienced OAB symptoms were eligible. We collected data on participants’ OAB symptoms, body weight changes, reasons for GLP-1 prescription, and demographics. Data was analyzed using SAS® software, with significance set at p < 0.05.

Results:

Of 33 respondents, 27 identified as female and 6 male. All used semaglutide, primarily for weight loss (96.9%). Four had a urinary condition besides OAB. Eleven (33.3%) reported OAB symptom improvement after starting GLP-1 agonists with mean weight loss of 12.2%, but this was not significantly different from those with no change or worsening symptoms (8.4% and 10% mean weight loss, respectively; p = 0.24). Half of those with OAB episodes at least once daily experienced symptom improvement, compared to 7.7% with less frequent symptoms (p = 0.01). Of participants reporting symptom improvement, 90.91% experienced OAB daily (p = 0.01).

Conclusion:

While weight loss can improve OAB symptoms, the impact of GLP-1 agonists remains unclear. Our findings may suggest that those with more frequent OAB symptoms at baseline may derive greater benefit from GLP-1 agonists, offering a potential hypothesis for future investigation. Further studies are needed to explore how these medications impact management of OAB.

目的：探讨胰高血糖素样肽-1 （GLP-1）激动剂（通常用于糖尿病和肥胖症）对膀胱过动症（OAB）症状主观影响的初步数据，以指导未来更大规模的研究。方法：我们在网上论坛上进行匿名调查。使用GLP-1激动剂并经历OAB症状的18岁或以上的参与者符合条件。我们收集了受试者OAB症状、体重变化、GLP-1处方原因和人口统计数据。数据分析采用SAS®软件，显著性设置为p <；0.05.结果：在33名受访者中，女性27人，男性6人。所有患者均使用西马鲁肽，主要用于减肥（96.9%）。除OAB外，还有4人患有泌尿系统疾病。11人（33.3%）报告在使用GLP-1激动剂后OAB症状改善，平均体重减轻12.2%，但这与症状没有改变或恶化的患者没有显著差异(分别平均体重减轻8.4%和10%；P = 0.24)。每天至少一次OAB发作的患者中，有一半的患者症状有所改善，而症状较少的患者中，这一比例为7.7% （p = 0.01）。在报告症状改善的参与者中，90.91%每天经历OAB （p = 0.01）。结论：虽然减肥可以改善OAB症状，但GLP-1激动剂的影响尚不清楚。我们的研究结果可能表明，基线时OAB症状更频繁的患者可能从GLP-1激动剂中获得更大的益处，为未来的研究提供了一个潜在的假设。需要进一步的研究来探讨这些药物如何影响OAB的管理。

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引用次数: 0

Bladder wall abscess following surgical treatment of complicated diverticulitis: A case report 复杂性憩室炎手术后膀胱壁脓肿1例

Continence Reports

Pub Date : 2025-05-12 DOI: 10.1016/j.contre.2025.100086

Narjes Sweis , John Smith , Patrick Bladek , Steven Garzon , Omer Acar , Gerald Gantt

Bladder wall abscesses, though rare, pose significant diagnostic challenges due to their nonspecific presentation. This case presents a 47-year-old male with a history of complicated diverticulitis, who developed a bladder wall abscess following treatment for a colocutaneous fistula. Initial imaging showed bladder wall thickening, and the patient later presented with recurrent lower urinary tract symptoms and a fluid collection at the bladder dome. Despite negative urine cultures, antibiotic therapy, and no evidence of a colovesical fistula, the abscess recurred. The patient underwent cystoscopy and transurethral resection of the abscess. This minimally invasive approach was effective, and the patient had a full recovery with no further recurrence. This case emphasizes the need for timely evaluation and a broad differential diagnosis in patients with a history of diverticulitis and persistent bladder symptoms. It also adds valuable insights to the limited knowledge on managing rare bladder wall abscesses.

膀胱壁脓肿虽然罕见，但由于其非特异性表现，对诊断提出了重大挑战。这个病例是一个47岁的男性，有复杂的憩室炎病史，他在治疗结肠皮瘘后出现膀胱壁脓肿。最初的影像显示膀胱壁增厚，患者后来出现反复的下尿路症状和膀胱穹部积液。尽管尿培养阴性，抗生素治疗，没有膀胱瘘的证据，脓肿复发。病人接受膀胱镜检查及经尿道脓肿切除术。这种微创方法是有效的，患者完全恢复，没有进一步复发。本病例强调有憩室炎病史和持续性膀胱症状的患者需要及时评估和广泛的鉴别诊断。它也增加了宝贵的见解，以管理罕见的膀胱壁脓肿的有限知识。

引用次数: 0

Pharmacotherapy of bladder dysfunction — past, present and future 膀胱功能障碍的药物治疗-过去，现在和未来

Continence Reports

Pub Date : 2025-04-25 DOI: 10.1016/j.contre.2025.100080

Karl-Erik Andersson

Overactive bladder (OAB) encompasses a variety of conditions that may necessitate different therapeutic strategies. This diversity is evident in the wide range of medications used over the past five decades. Unfortunately, we have too few tools to identify individual conditions and even less information about which condition is best served by which treatment. Many of the drugs have been discontinued primarily due to an unfavorable balance between efficacy and adverse effects. As a result, current treatment guidelines primarily recommend antimuscarinics and

β

3-adrenoceptor agonists, with intravesical botulinum toxin injections as a second-line option. While these treatments have documented efficacy, their use is often limited by side effects, adherence challenges, and persistence issues. Personalized treatment approaches may help optimize the use of these medications. However, there is a need for improved therapies, and many promising future therapeutic alternatives can be discussed. However, there seem to be no drugs ready for immediate clinical introduction.

膀胱过动症（OAB）包括多种情况，可能需要不同的治疗策略。这种多样性在过去五十年中广泛使用的药物中是显而易见的。不幸的是，我们很少有工具来识别个体疾病，更少的信息是，哪种治疗方法对哪种疾病最有效。许多药物已经停止使用，主要是由于疗效和副作用之间的不利平衡。因此，目前的治疗指南主要推荐抗蛇毒素和β3-肾上腺素受体激动剂，膀胱内注射肉毒杆菌毒素作为二线选择。虽然这些治疗方法有文献记载的疗效，但它们的使用往往受到副作用、依从性挑战和持久性问题的限制。个性化治疗方法可能有助于优化这些药物的使用。然而，需要改进治疗方法，并且可以讨论许多有希望的未来治疗方案。然而，目前似乎还没有可以立即用于临床的药物。

引用次数: 0

The efficacy of the P-funnel, an external urinary collection device, for females in a hospital setting p -漏斗，一种体外尿液收集装置，对女性在医院设置的有效性

Continence Reports

Pub Date : 2025-04-21 DOI: 10.1016/j.contre.2025.100082

Vania Chang (M.S.) , Joan M. Ching (R.N., D.N.P.) , Randal P. Ching (Ph.D.)

Objectives: For females with limited mobility, toileting can be challenging, and effective options that foster independence and continence are few. This study examines the usability and effectiveness of the P-funnel^TM, a new external urinary collection device for females with mobility challenges, and postulates its potential for increasing independence, reducing risks for infection and skin breakdown, and sustaining continence.

Study Design: Prospective, single-center, survey study of hospitalized female volunteers.

Methods: Fourteen hospitalized female patients who met the eligibility criteria were enrolled in this study. Each participant was trained on the use of the P-funnel, performed at least one supine void, then completed a 5-point Likert questionnaire. The survey questions focused on comfort, ease of use, and functionality.

Results: The participant’s average satisfaction rating across the 10 question survey was 4.37 out of 5. For overall comfort, 85.8% of the participants scored the P-funnel as 4 or higher (out of 5). For questions concerning ease of use, 92.9% agreed the device was easy to position, and 85.8% agreed it was not difficult to hold the funnel in place while peeing. While 42.9% of the participants did encounter some leakage during use, 90.9% felt the P-funnel was easier to use than what they were currently using and 100% agreed that they would able to use the device confidently and would recommend it to others.

Conclusions: Overall the P-funnel functioned well with generally high satisfaction scores for ease of use and comfort. And, for females with ambulatory difficulty, it has the potential to increase independence and reduce the hazards associated with toileting.

目的：对于行动不便的女性来说，如厕可能是一项挑战，而培养独立和自制能力的有效选择很少。本研究考察了p -漏斗tm的可用性和有效性，p -漏斗tm是一种针对行动不便的女性的新型外尿收集装置，并假设其具有提高独立性、降低感染和皮肤破裂风险以及维持尿失禁的潜力。研究设计：前瞻性、单中心、住院女性志愿者调查研究。方法：选取符合入选标准的14例住院女性患者。每个参与者都接受了使用p漏斗的培训，进行了至少一次仰卧空，然后完成了5点李克特问卷。调查问题集中在舒适度、易用性和功能性上。结果：在10个问题的调查中，参与者的平均满意度为4.37分（满分5分）。就整体舒适度而言，85.8%的参与者将p -漏斗得分为4或更高（满分为5分）。对于易用性问题，92.9%的人认为该装置易于定位，85.8%的人认为在小便时将漏斗固定在适当的位置并不困难。虽然42.9%的参与者在使用过程中确实遇到了一些泄漏，但90.9%的人认为p漏斗比他们目前使用的更容易使用，100%的人同意他们能够自信地使用该设备并将其推荐给其他人。结论：总体而言，p -漏斗功能良好，对易用性和舒适性的满意度得分普遍较高。而且，对于行走困难的女性来说，它有可能增加独立性，减少与如厕有关的危险。

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引用次数: 0

Sling plication for failed midurethral sling surgery to treat female stress urinary incontinence 应用吊带治疗女性压力性尿失禁失败的中尿道吊带手术

Continence Reports

Pub Date : 2025-04-21 DOI: 10.1016/j.contre.2025.100081

Eva M.P. Remmen, John P.F.A. Heesakkers

Introduction:

Stress urinary incontinence (SUI) is a common problem in women. When conservative therapy fails, surgical interventions should be considered. Midurethral slings (MUSs) were introduced in the 1990s and have been the golden standard for surgical treatment of SUI. Despite being the golden standard among several different surgical options for SUI, failure rates vary from 8% to 57%. There is no defined standard of care after failed MUS. Sling plication is a less invasive procedure compared to other surgical options, however data is relatively scarce.

Methods:

Three women who underwent sling plication for persistent SUI after retropubic MUS were identified. Sling plication was performed by the same physician. The polypropylene sling was isolated and cut medially. Sling ends were then folded over each other and fixated with prolene sutures. Tensioning of the sling was based on the subjective assessment of the surgeon. Subjective and objective findings were collected before initial placement of MUS, after placement of MUS and at six and twelve weeks after plication of MUS.

Results:

All three women had a satisfactory reduction of SUI symptoms after sling plication. Reduction in pad use was clinically relevant, decreasing from two to six large pads to a maximum of two small pads a day. There were no post-operative complications. All women would recommend sling plication to others in the same situation.

Conclusion:

Sling plication is an effective, safe and less invasive way of treating persistent or recurrent SUI after midurethral sling surgery and should be considered when counselling patients after failed MUS. Further research with bigger study populations, standardised methods to quantify improvement after plication and longer follow-up is needed to verify our positive results.

摘要压力性尿失禁（Stress urinary incontinence， SUI）是女性的常见病。当保守治疗失败时，应考虑手术干预。中尿道吊带术（MUSs）在20世纪90年代被引入，并已成为SUI手术治疗的黄金标准。尽管这是治疗SUI的几种不同手术选择中的黄金标准，但失败率从8%到57%不等。在MUS失败后，没有明确的护理标准。与其他手术选择相比，Sling应用是一种侵入性较小的手术，然而数据相对较少。方法：对3例耻骨后MUS术后持续性SUI行吊带治疗的妇女进行分析。Sling应用是由同一位医生完成的。将聚丙烯吊带隔离，中间切开。然后将吊索两端相互折叠，并用prolene缝线固定。吊带的张力是基于外科医生的主观评估。主观和客观的结果收集在初始放置MUS之前，放置MUS之后，在应用MUS后的第6周和第12周。结果：所有三名妇女在使用吊带后SUI症状都得到了满意的减轻。减少垫的使用与临床相关，从每天2到6个大垫减少到最多2个小垫。无术后并发症。所有女性都会建议其他人在同样的情况下使用sling。结论：应用吊带是治疗尿道中悬吊术后持续或复发性SUI的一种有效、安全、微创的治疗方法，在治疗失败患者时应予以考虑。进一步的研究需要更大的研究人群，标准化的方法来量化应用后的改善和更长时间的随访来验证我们的积极结果。

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引用次数: 0

Urinary continence outcomes during the transition from laparoscopic to robotic assisted radical prostatectomy: A single surgeon’s Australian regional centre experience 从腹腔镜到机器人辅助根治性前列腺切除术过渡期间的尿失禁结果：一位外科医生在澳大利亚区域中心的经验

Continence Reports

Pub Date : 2025-03-25 DOI: 10.1016/j.contre.2025.100079

Basil Razi , Dane Cole-Clark , Duncan Self , Mark Louie-Johnsun

Introduction & Objectives:

Robotic assisted laparoscopic radical prostatectomy (RARP) is becoming standard of care for prostate cancer patients requiring surgical intervention. Postoperative continence significantly impacts patients’ quality of life, making functional outcomes a critical focus in the evolution of surgical techniques. Alternative methods, including open and laparoscopic techniques, have been superseded with increased availability of robotic units within Australia. This study aims to review an experienced laparoscopic surgeon’s transition to robotic prostatectomy and the impact on continence.

Methods:

Prospective data collection included patient demographics, surgical method, and pad usage at 3 and 12 months postoperatively. The final 100 laparoscopic radical prostatectomy (LRP) cases (May 2019–August 2021) were compared with the first 100 RARP cases (August 2021–February 2023), all performed by the same surgeon. Continence rates were assessed using patient-reported pad usage.

Results:

The mean age was similar between LRP (65.3 years) and RARP (65.4 years) groups. Continence rates at 3 and 12 months were 67.0% and 90.4% for LRP patients versus 78% and 94% for RARP patients. Odds ratio analysis indicated LRP patients were 1.75 and 1.66 times more likely to be incontinent at 3 and 12 months, respectively.

Conclusion:

RARP demonstrated higher continence rates without evidence of a learning curve during the transition from LRP. These findings underscore the potential for improved patient outcomes with wider adoption of robotic systems in Australia.

介绍,目的：机器人辅助腹腔镜根治性前列腺切除术（RARP）正在成为需要手术干预的前列腺癌患者的标准治疗方法。术后尿失禁显著影响患者的生活质量，使功能结局成为外科技术发展的关键焦点。替代方法，包括开放和腹腔镜技术，已经取代了越来越多的机器人单位在澳大利亚。本研究旨在回顾一位经验丰富的腹腔镜外科医生向机器人前列腺切除术的过渡及其对尿失禁的影响。方法：前瞻性数据收集包括术后3个月和12个月的患者人口统计学、手术方法和尿垫使用情况。最后100例腹腔镜根治性前列腺切除术（LRP）病例（2019年5月- 2021年8月）与前100例RARP病例（2021年8月- 2023年2月）进行比较，所有病例均由同一外科医生进行。根据患者报告的尿垫使用情况评估尿失禁率。结果：LRP组与RARP组患者平均年龄相近（65.3岁）。LRP患者3个月和12个月的尿失禁率分别为67.0%和90.4%，而RARP患者为78%和94%。优势比分析显示，LRP患者在3个月和12个月时发生尿失禁的可能性分别是1.75倍和1.66倍。结论：在从LRP过渡到rrp的过程中，RARP显示出更高的控制率，没有证据表明有学习曲线。这些发现强调了在澳大利亚广泛采用机器人系统可以改善患者预后的潜力。

{"title":"Urinary continence outcomes during the transition from laparoscopic to robotic assisted radical prostatectomy: A single surgeon’s Australian regional centre experience","authors":"Basil Razi , Dane Cole-Clark , Duncan Self , Mark Louie-Johnsun","doi":"10.1016/j.contre.2025.100079","DOIUrl":"10.1016/j.contre.2025.100079","url":null,"abstract":"<div><h3>Introduction & Objectives:</h3><div>Robotic assisted laparoscopic radical prostatectomy (RARP) is becoming standard of care for prostate cancer patients requiring surgical intervention. Postoperative continence significantly impacts patients’ quality of life, making functional outcomes a critical focus in the evolution of surgical techniques. Alternative methods, including open and laparoscopic techniques, have been superseded with increased availability of robotic units within Australia. This study aims to review an experienced laparoscopic surgeon’s transition to robotic prostatectomy and the impact on continence.</div></div><div><h3>Methods:</h3><div>Prospective data collection included patient demographics, surgical method, and pad usage at 3 and 12 months postoperatively. The final 100 laparoscopic radical prostatectomy (LRP) cases (May 2019–August 2021) were compared with the first 100 RARP cases (August 2021–February 2023), all performed by the same surgeon. Continence rates were assessed using patient-reported pad usage.</div></div><div><h3>Results:</h3><div>The mean age was similar between LRP (65.3 years) and RARP (65.4 years) groups. Continence rates at 3 and 12 months were 67.0% and 90.4% for LRP patients versus 78% and 94% for RARP patients. Odds ratio analysis indicated LRP patients were 1.75 and 1.66 times more likely to be incontinent at 3 and 12 months, respectively.</div></div><div><h3>Conclusion:</h3><div>RARP demonstrated higher continence rates without evidence of a learning curve during the transition from LRP. These findings underscore the potential for improved patient outcomes with wider adoption of robotic systems in Australia.</div></div>","PeriodicalId":100330,"journal":{"name":"Continence Reports","volume":"14 ","pages":"Article 100079"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transvaginal mechanotherapy for stress urinary incontinence: Principles, cellular and neuromuscular mechanisms of action, and comparison to current gold standard treatments 经阴道机械治疗压力性尿失禁：原理，细胞和神经肌肉的作用机制，并与目前的金标准治疗比较

Continence Reports

Pub Date : 2025-01-15 DOI: 10.1016/j.contre.2024.100077

Alisha Fulker , Shravya Kovela , Marcus Mianulli

Mechanotransduction is a scientific principle by which cells sense and respond to mechanical stimuli. Mechanotherapy is the clinical application of mechanotransduction for tissue repair in muscle rehabilitation. Pelvic floor muscle training (PFMT) is currently the conservative gold standard of care for treatment of women with stress urinary incontinence (SUI). Mechanotherapy can increase the effectiveness of PFMT, especially when applied intravaginally for a direct transvaginal treatment to the pelvic floor muscles. With an understanding of the benefits of mechanotherapy, its mechanisms of action, and the resulting neuromuscular recruitment leading to the long-term durability of continence results, transvaginal mechanotherapy has the potential to become a complimentary first-line standard of care for women with SUI.

机械转导是细胞感知和响应机械刺激的科学原理。机械疗法是机械转导在肌肉康复中组织修复的临床应用。盆底肌肉训练（PFMT）是目前治疗女性压力性尿失禁（SUI）的保守金标准。机械疗法可以提高PFMT的有效性，特别是当经阴道直接治疗骨盆底肌肉时。了解机械疗法的益处，其作用机制，以及由此产生的神经肌肉招募导致尿失禁结果的长期持久性，经阴道机械疗法有可能成为SUI女性的一线护理标准。

引用次数: 0

Intravesical migration of intrauterine device: Case report and literature review 宫内节育器膀胱内移位：病例报告及文献复习

Continence Reports

Pub Date : 2024-12-01 DOI: 10.1016/j.contre.2024.100074

Gamal M. Ghoniem , Tivoli Nguyen

Intrauterine devices are a commonly used method of female contraception that has become increasingly popular worldwide because they are highly effective and convenient to use. However, complications, such as migration to nearby viscera or peritoneal cavity, can occur. The bladder is an especially uncommon destination for migration. Here, we report a rare case of IUD intravesical migration in a 30-year-old female patient presenting with lower abdominal pain and menorrhagia who had an IUD placed 8 years prior.

宫内节育器是一种常用的女性避孕方法，由于其高效方便，在世界范围内越来越受欢迎。然而，并发症，如迁移到附近的脏器或腹腔，可能发生。膀胱是一个特别罕见的迁移目的地。在此，我们报告一例罕见的宫内节育器膀胱内移位的病例，患者为30岁，前放置宫内节育器8年，现表现为下腹痛和月经过多。

引用次数: 0

Role of videourodynamics, imaging, and cystoscopy in patients with recurrent urinary tract infections: Should we throw in the kitchen sink? 视频动力、成像和膀胱镜检查在复发性尿路感染患者中的作用：我们是否应该把厨房水槽扔进去？

Continence Reports

Pub Date : 2024-11-08 DOI: 10.1016/j.contre.2024.100073

G. Chan , F. Davidovic , J. Gani

Purpose:

Recurrent urinary tract infection (rUTI) remains a common outpatient problem with discordance and paucity of evidence for management. This study aims to evaluate the role of videourodynamics (VUD), additional imaging, and cystoscopy in the complete workup of these patients.

Materials and Methods:

A retrospective review was performed on 1421 consecutive patients referred for physician performed VUD. After exclusion criteria, 170 patients were included. Ethics approval was obtained, followed by data collection, and analysis of demographics, symptoms, cystoscopy results, imaging, and VUD parameters. Statistical analyses were performed with IBM SPSS Statistics Version 28. Statistical significance was defined by an alpha level of P

\leq 0.05

.

Results:

Overall, 117/170 (69%) had identifiable causes of rUTI identified on VUD. There was a statistically significant difference (p<0.001) in identifying a cause in those with voiding symptoms (93/114

=

82%) compared to those without (24/56

=

43%). Gender was not predictive of an identifiable cause on VUD (

p = 0.47

). Neither was a neurogenic history (

p = 0.11

), diabetes (

p = 0.97

), or age (

p = 0.89

). Additional imaging was not diagnostic for rUTI cause. No malignancy was identified on imaging or cystoscopy.

Conclusion:

In patients with rUTI, VUD may be an important investigative step to find a possible underlying cause, but it is a scarce resource. As VUD has a higher detection rate in patients with voiding symptoms, by first screening for these patients on history, VUD can be used judiciously. Cystoscopy and additional imaging were not as helpful in identifying a target treatment plan for rUTI, when a VUD had already been done.

目的：复发性尿路感染（rUTI）仍是一个常见的门诊问题，其治疗方法不统一且缺乏证据。本研究旨在评估视频动力疗法（VUD）、附加影像学检查和膀胱镜检查在这些患者的全面检查中的作用。根据排除标准，共纳入 170 名患者。该研究获得了伦理批准，随后进行了数据收集，并对人口统计学、症状、膀胱镜检查结果、影像学和 VUD 参数进行了分析。统计分析采用 IBM SPSS 统计 28 版进行。结果：总体而言，有 117/170 人（69%）在 VUD 上发现了可确定的 rUTI 病因。与无排尿症状者（24/56 = 43%）相比，有排尿症状者（93/114 = 82%）在确定病因方面存在显著差异（P<0.001）。性别并不能预测 VUD 的病因（p=0.47）。神经源性病史（p=0.11）、糖尿病（p=0.97）或年龄（p=0.89）也不能预测。其他影像学检查不能诊断 rUTI 病因。结论：对于 rUTI 患者，VUD 可能是寻找可能潜在病因的重要检查步骤，但它是一种稀缺资源。由于VUD在有排尿症状的患者中检出率较高，因此首先根据病史对这些患者进行筛查，可以明智地使用VUD。如果已经进行了 VUD 检查，那么膀胱镜检查和其他影像学检查对于确定 rUTI 的目标治疗方案并没有那么有帮助。

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引用次数: 0

Safety and efficacy of artificial urinary sphincter versus male slings in treatment of male urinary incontinence: Systematic review and meta-analysis 人工尿道括约肌与男性吊带治疗男性尿失禁的安全性和有效性：系统回顾和荟萃分析

Continence Reports

Pub Date : 2024-11-08 DOI: 10.1016/j.contre.2024.100070

Bagrat Grigoryan , George Kasyan , Roman Shapovalenko , Dmitry Pushkar

Background and objective:

Male stress urinary incontinence (UI) remains a serious problem associated with a significant quality of life reduction. The aim of this study is to determine the safety and effectiveness of artificial urinary sphincter (AUS) and male slings (MS) for stress UI in men.

Evidence acquisition:

Inclusion criteria: randomized/non-randomized trials evaluating adult men with stress UI. Exclusion criteria: repeated SUI surgery, combined conservative interventions and pharmacological treatment. The electronic databases were searched up to January 2024. The systematic review was conducted according to PICO framework and PRISMA 2020 guidelines and was registered in PROSPERO. The risk of bias was evaluated using the tools recommended by the Cochrane Society.

Evidence synthesis:

Thirteen clinical trials were included in the systematic review, and 11 in the meta-analysis. There was no statistically significant difference in the improvement rate between AUS and MS (RR

=

0.93, 95% CI: [0.85, 1.02], p

=

0.13). MS showed statistically significant fewer infectious complication (RR

=

3.26, 95% CI: [1.97, 5.39], p<0.00001), device explantation (RR

=

3.29, 95% CI: [2.46, 4.41], p<0.00001), surgical revision (RR

=

2.27, 95% CI: [1.60, 3.20], p<0.00001), urinary retention (RR

=

0.04, 95% CI: [0.01, 0.07], p

=

0.004) rates and operation time (RR

=

0.93, 95% CI: [0.85, 1.02], p

=

0.13) compared with AUS.

Conclusion:

AUS demonstrates a comparable improvement level to MS. The operation time, infectious complication, device explantation, urinary retention, and surgical revision rates were lower in MS. More randomized and prospective studies with long-term follow-up will further increase confidence in the choice between AUS and MS for male UI treatment.

背景和目的：男性压力性尿失禁（UI）仍然是一个严重的问题，会严重降低生活质量。本研究旨在确定人工尿道括约肌（AUS）和男性吊带（MS）治疗男性压力性尿失禁的安全性和有效性。证据获取：纳入标准：评估成年男性压力性尿失禁的随机/非随机试验。排除标准：重复 SUI 手术、联合保守干预和药物治疗。对电子数据库的检索截止到2024年1月。该系统性综述根据PICO框架和PRISMA 2020指南进行，并在PROSPERO中进行了注册。证据综述：13项临床试验被纳入系统综述，11项被纳入荟萃分析。AUS和MS的改善率在统计学上没有明显差异（RR=0.93，95% CI：[0.85，1.02]，P= 0.13）。MS 的感染性并发症（RR = 3.26，95% CI：[1.97, 5.39]，p<0.00001）、装置拆卸（RR = 3.29，95% CI：[2.46, 4.41]，p<0.00001）、手术翻修（RR = 2.27，95% CI：[1.60, 3.20]，p<0.00001）、尿潴留（RR = 0.04，95% CI：[0.01，0.07]，p = 0.004）率和手术时间（RR = 0.93，95% CI：[0.85，1.02]，p = 0.13）与 AUS 相比。结论：AUS的改善程度与MS相当，但MS的手术时间、感染并发症、装置拆卸、尿潴留和手术翻修率更低。更多长期随访的随机和前瞻性研究将进一步增强在男性尿失禁治疗中选择AUS和MS的信心。

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引用次数: 0