(PD2-3) Prospective evaluation of pelvic floor muscle training and male sling for male postprostatectomy stress urinary incontinence
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  • 2015-11-30,
  • 上傳者: TUA秘書處,
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前瞻性評估骨盆底肌肉再訓練和男性吊帶治療男性攝護腺切除後應力性尿失禁
王炯珵a,b    陳柏誠a 
恩主公醫院 泌尿科
Prospective evaluation of pelvic floor muscle training and male sling for male postprostatectomy stress urinary incontinence

Chung-Cheng Wanga,b, Po-Cheng Chena

aDepartment of Urology, En Chu Kong Hospital, Taipei, Taiwan
bDepartment of Biomedical Engineering, Chung Yuan Christian University, Taiwan
 
Purpose:
Persistent stress urinary incontinence (SUI) occurs approximate 10% ~30% patients after radical prostatectomy (RP). The aim of the study was to evaluate the effectiveness and safety of the pelvic floor muscle training (PFMT) and retrourethral transobturator sling for the treatment of male SUI.
Materials and Methods:
This study documents a single-center prospective evaluation of the outcome of 26 patients with SUI following RP in whom received PFMT and male sling between 2012 Feb and 2015 Feb. All patients were comprehensively evaluated pre-training, post-training, preoperatively and after 6 months regarding daily pad use, ULCA male incontinence questionnaires, patients’ satisfaction, post-voiding residual urine and complications.
Results:
The mean patients’ age was 69.3 ± 7.7 years (range 63-82) and the mean pad use was 3.7 ± 2.6 per day (range 1-7). Baseline urodynamic study showed mean Qmax was 12.8 ± 8.0mL, voided volume was 161 ± 126mL, PVR was 19 ± 30mL, ALPP was  48.9 ± 34.2 cmH2O and CLPP was 68.6 ± 25.1cmH2O. After 12 courses of pelvic floor retraining in 3 months, The use of daily pad was significantly decreased from 3.7± 2.6 to 2.4 ± 1.5, p=0.02. However the UCLA score was not significantly changed (82.8 ± 75.1 to 70.2 ± 34, p=0.25). The patients’ satisfactory rate was 40%. Of them, 12 patients received transobturator male sling after failed conservative treatment. Retrograde urethral pressure profile was measured with 60cmH2O leakage point pressure setting after placing sling. Compared with preoperative status, the use of daily pad was significantly decreased from 4.7 ± 2.3 to 0.5 ± 1.0, p<0.001. The UCLA score was significantly increased from 62.0 ± 40.3 to 248 ± 177, p<0.001. The overall patients’ satisfactory rate was 91.7%. One patient suffered from temporary acute urinary retention and one patient had perineal skin erosion.
Conclusions:
Conservative treatment has limited effects for male SUI after RP. Mail sling is an effective and safe procedure for treatment of male SUI during the short-term followup.
 
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    2015-11-30 10:40:00
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