دورية أكاديمية
Urodynamic effects of volume-adjustable balloons for treatment of postprostatectomy urinary incontinence.
العنوان: | Urodynamic effects of volume-adjustable balloons for treatment of postprostatectomy urinary incontinence. |
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المؤلفون: | Utomo E; Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands. e.utomo@erasmusmc.nl, Groen J, Vroom IH, van Mastrigt R, Blok BF |
المصدر: | Urology [Urology] 2013 Jun; Vol. 81 (6), pp. 1308-14. Date of Electronic Publication: 2013 Mar 07. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Science Country of Publication: United States NLM ID: 0366151 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-9995 (Electronic) Linking ISSN: 00904295 NLM ISO Abbreviation: Urology Subsets: MEDLINE |
أسماء مطبوعة: | Publication: New York : Elsevier Science Original Publication: Ridgewood, N.J., Professional Medical Services Co. |
مواضيع طبية MeSH: | Prostheses and Implants* , Urodynamics*, Urinary Incontinence, Stress/*physiopathology , Urinary Incontinence, Stress/*therapy, Absorbent Pads ; Aged ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Muscle Contraction ; Prostatectomy/adverse effects ; Retrospective Studies ; Severity of Illness Index ; Time Factors ; Urinary Bladder/physiopathology ; Urinary Bladder, Overactive/physiopathology ; Urinary Incontinence, Stress/etiology |
مستخلص: | Objective: To evaluate the urodynamic changes in patients treated with Adjustable Continence Therapy for men (ProACT) for postprostatectomy incontinence and to explore the clinical and urodynamic preimplantation parameters as predictors of clinical outcome. Materials and Methods: Patients underwent urodynamic studies before and after ProACT implantation. ProACT was considered successful if patients used none or 1 dry precautionary pad and nonsuccessful if the patient reported ≥1 wet pad/d. The pre- and postimplantation assessments were retrospectively compared within and between the success and nonsuccess groups. Multivariate logistic regression analysis was performed to investigate the association between the preimplantation variables and the clinical outcomes of ProACT implantation. Results: A total of 49 patients were included, 37 with successful and 12 with nonsuccessful clinical outcome. Postimplantation urodynamic studies were performed a median of 9 months after ProACT implantation. In the successfully treated patients, maximum free flow rate, bladder contractility index, maximum of bladder contractility parameter W, and bladder voiding efficiency were significantly lower after implantation. The detrusor pressure at maximum flow rate, postvoid residual urine volume, and bladder outlet obstruction index were significantly higher. A longer duration of urinary incontinence, the use of >5 pads daily, and a smaller cystometric bladder capacity were all independently associated with nonsuccessful clinical outcome after ProACT implantation. Conclusion: ProACT implantation with successful clinical outcome resulted in greater urethral resistance during voiding and reduced bladder contraction strength. A longer duration of incontinence, the use of >5 pads daily, and a smaller cystometric bladder capacity were independent predictors of unsuccessful clinical outcomes, suggesting ProACT implantation should be considered sooner, rather than later, after conservative treatment of postprostatectomy incontinence has failed. (Copyright © 2013 Elsevier Inc. All rights reserved.) |
تواريخ الأحداث: | Date Created: 20130308 Date Completed: 20130823 Latest Revision: 20130603 |
رمز التحديث: | 20240628 |
DOI: | 10.1016/j.urology.2013.01.020 |
PMID: | 23465144 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1527-9995 |
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DOI: | 10.1016/j.urology.2013.01.020 |