背景:比较接受或不接受放疗(RT)的人工尿道括约肌(AUS)患者的失禁发生率和并发症。
方法:PubMed,Embase,ScienceDirect,中部,搜索和GoogleScholar数据库,以比较有和没有RT的患者之间的AUS结局。搜索限制为2002年1月1日至2021年9月15日。
结果:共纳入18项研究。荟萃分析显示,与无RT组相比,RT组没有尿失禁的几率显着降低(OR:0.3595%CI:0.21,0.59I2=51%p<0.0001)。我们还注意到RT组中翻修手术的风险显著增加(OR:1.7495%CI:1.16,2.60I2=73%p=0.07)。在RT组中,感染风险增加(OR:2.5195%CI:1.00,6.29I2=46%p=0.05)和糜烂风险增加(OR:2.0095%CI:1.15,3.45I2=21%p=0.01),但差异仅在糜烂方面显着。荟萃分析显示,放疗患者的移植风险有统计学意义(OR:3.0095%CI:1.16,7.75I2=68%p=0.02),但两组间尿道萎缩(OR:1.1895%CI:0.47,2.94I2=46%p=0.72)和机械故障(OR:0.9095%CI:0.25,3.27I2=54%p=0.87)的风险无差异。
结论:我们对最近研究的荟萃分析表明,RT可显著降低AUS置入后实现完全失禁的几率。RT的历史不会增加AUS患者尿道萎缩或机械故障的风险。然而,翻修手术的风险,RT患者的糜烂和外植体显着增加,感染趋势不明显,但增加。
背景:https://www.crd.约克。AC.英国/普华永道/,标识符:NCT02612389。
BACKGROUND: To compare incontinence rates and complications in patients receiving artificial urinary sphincter (AUS) with or without radiotherapy (RT).
METHODS: PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases were searched for studies comparing outcomes of AUS between patients with and without RT. Search limits were from 1st January 2002 to 15th September 2021.
RESULTS: Eighteen studies were included. Meta-analysis revealed statistically significant reduced odds of the absence of incontinence in the RT group (OR: 0.35 95% CI: 0.21, 0.59 I 2 = 51% p < 0.0001) as compared to the no-RT group. We also noted statistically significant increased risk of revision surgery in the RT group (OR: 1.74 95% CI: 1.16, 2.60 I 2 = 73% p = 0.07). There was increased risk of infections (OR: 2.51 95% CI: 1.00, 6.29 I 2 = 46% p = 0.05) and erosions (OR: 2.00 95% CI: 1.15, 3.45 I 2 = 21% p = 0.01) in the RT group, but the difference was significant only for erosions. Meta-analysis revealed a statistically significant increased risk of explantation in patients with RT (OR: 3.00 95% CI: 1.16, 7.75 I 2 = 68% p = 0.02) but there was no difference in the risk of urethral atrophy (OR: 1.18 95% CI: 0.47, 2.94 I 2 = 46% p = 0.72) and mechanical failure (OR: 0.90 95% CI: 0.25, 3.27 I 2 = 54% p = 0.87) between the two groups.
CONCLUSIONS: Our meta-analysis of recent studies indicates that RT significantly reduces the odds of achieving complete continence after AUS placement. History of RT does not increase the risk urethral atrophy or mechanical failure in patients with AUS. However, the risk of revision surgery, erosions and explantations is significantly increased in patients with RT with a non-significant but increased tendency of infections.
BACKGROUND: https://www.crd.york.ac.uk/prospero/, identifier: NCT02612389.