背景:人工尿道括约肌和3件式可膨胀阴茎假体各自需要流体储存部件,因此在腹股沟和骨盆区域具有部件。正因为如此,在未来的非假体手术中,泌尿外科假体患者有时会面临挑战。目前,对于随后的腹股沟或骨盆手术的器械管理,目前尚无既定指南.
目的:本文概述了人工尿道括约肌和/或充气阴茎假体患者在骨盆和腹股沟手术期间的注意事项,并提出了术前手术计划和决策的算法。
方法:我们对这些假体装置的手术管理文献进行了叙述性回顾。通过搜索电子数据库确定出版物。本次审查仅考虑了经同行评审的英文出版物。
结果:我们回顾了在随后的非假体手术中这些假体装置的手术管理的重要考虑因素以及可用的选择,并强调了每种方法的优缺点。最后,我们提出了一个框架来帮助外科医生确定哪种管理策略最适合他们的个体患者.
结论:最佳管理策略将根据患者价值而有所不同,计划中的手术,和患者特定因素。外科医生应了解和咨询患者的所有可用的选择,并鼓励知情,共同决策,以确定最佳的个性化方法。
The artificial urinary sphincter and 3-piece inflatable penile prosthesis each require a fluid storage component and thus have components in the inguinal and pelvic regions. Because of this, patients with urologic prosthetics sometimes present challenges during future nonprosthetic operations. Presently, there is no established guideline for device management with ensuing inguinal or pelvic surgery.
This article outlines concerns during pelvic and inguinal surgery for patients with an artificial urinary sphincter and/or inflatable penile prosthesis and proposes an algorithm for preoperative surgical planning and decision making.
We conducted a narrative review of the literature on operative management of these prosthetic devices. Publications were identified by searching electronic databases. Only peer-reviewed publications available in English were considered for this review.
We review the important considerations as well as available options for operative management of these prosthetic devices during subsequent nonprosthetic surgery and highlight the advantages and disadvantages of each. Finally, we suggest a framework for helping surgeons determine which management strategy is most appropriate for their individual patients.
The best management strategy will differ depending on patient values, the planned surgery, and patient-specific factors. Surgeons should understand and counsel patients on all available options and encourage informed, shared decision making to determine the best individualized approach.