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Int J Urol ; 24(4): 308-313, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28215049

RESUMO

OBJECTIVES: To analyze the safety and the mid-term continence rates of laparoscopic implantation of artificial urinary sphincter in women. METHODS: A total of 52 women with intrinsic sphincter deficiency underwent a laparoscopic artificial urinary sphincter implantation from 2005 to 2015 at Surgical Clinic Du Pré, Le Mans, France. The artificial urinary sphincter was implanted around the bladder neck by a transperitoneal laparoscopic approach to the Retzius space. Urodynamic assessment was carried out. Postoperative functional outcome was defined as success (no leaking, no pad use), improvement (>50% decrease in number of leakages, >50% decrease in number of pads used or use of light protection) or failure (<50% improvement, persistent or increased leaking). Outcome measures also included perioperative and long-term complications. RESULTS: The mean age of the patients was 69.1 years (range 64-82 years). After a mean follow up of 37.5 months (median 24 months; range 1-125 months), 38 (77.6%) patients were considered to be continent (no leakage, no pads), and eight (16.3%) improved their grade of incontinence. Three patients abandoned the follow-up schedule and were excluded. There was no perioperative severe complication. Artificial urinary sphincter revision was needed in 11 (22.4%) patients, requiring a total of seven redo procedures and four permanent sphincter removals. The main reasons for redo procedures were six (11.2%) mechanical problems and one vaginal erosion (2%). CONCLUSIONS: Herein we report one of the largest series with the longest follow up evaluating the outcomes of laparoscopic artificial urinary sphincter implantation in female patients. This approach seems to be a safe and effective treatment option for patients with intrinsic sphincter deficiency.


Assuntos
Laparoscopia/efeitos adversos , Uretra/cirurgia , Incontinência Urinária por Estresse/cirurgia , Esfíncter Urinário Artificial/efeitos adversos , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Tampões Absorventes para a Incontinência Urinária/estatística & dados numéricos , Laparoscopia/métodos , Período Pós-Operatório , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento , Uretra/fisiopatologia , Incontinência Urinária por Estresse/fisiopatologia , Urodinâmica/fisiologia , Procedimentos Cirúrgicos Urológicos/métodos
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