Abstract:
UNASSIGNED: The artificial urinary sphincter (AUS) has been used to treat post-prostatectomy incontinence in men for decades with excellent outcomes and low complication rates. A successful AUS placement can dramatically improve the quality of life in men with stress urinary incontinence. Consequently, complications in this population can be devastating for the patient. One of the most troublesome complications is cuff erosion, which necessitates explantation of the device and dooms a man to recurrent incontinence. While the device can be replaced, device replacements are fraught with high erosion rates. Furthermore, it is not uncommon for men undergoing AUS placement to have multiple medical comorbidities that make urgent surgery for explantation unideal. Nonetheless, men with cellulitis and significant symptoms must undergo removal of an eroded AUS. There is little to no literature published on the timing or need for device removal in the man who has an asymptomatic erosion.
UNASSIGNED: We report a case series of five men undergoing delayed or no explantation of an asymptomatic cuff erosion. All five men were asymptomatic at the time of presentation and underwent a delayed explant or no explant. No man required urgent device explant while the erosion was present.
UNASSIGNED: Urgent device explantation may not be necessary in the asymptomatic AUS cuff erosion, and further study may be able to elucidate men who can avoid removal of cuff erosion when no symptoms are present.
摘要:
■数十年来,人工尿道括约肌(AUS)已用于治疗男性前列腺切除术后尿失禁,效果良好,并发症发生率低。成功的AUS放置可以显着改善患有压力性尿失禁的男性的生活质量。因此,该人群的并发症对患者可能是毁灭性的。最麻烦的并发症之一是袖口侵蚀,这就需要移植该装置,并注定一个人复发性尿失禁。虽然可以更换设备,设备更换充满了高侵蚀率。此外,接受AUS安置的男性有多种医疗合并症并不少见,这些合并症使得紧急外植体手术变得不常见.尽管如此,患有蜂窝织炎和明显症状的男性必须接受AUS侵蚀的去除。关于无症状侵蚀的男性的设备移除时间或需要的文献很少或没有发表。
■我们报告了一个病例系列,该病例系列有5名男性接受了无症状的袖口糜烂的延迟移植或无移植。所有五名男性在就诊时无症状,并且经历了延迟外植体或无外植体。侵蚀存在时,没有人需要紧急装置外植体。
■在无症状的AUS袖口侵蚀中,可能不需要紧急装置外植术,进一步的研究可能能够阐明男性在没有症状的情况下可以避免去除袖带侵蚀。