Treatment of moderate to severe female stress urinary incontinence with the adjustable continence therapy (ACT) device after failed surgical repair

被引:20
作者
Aboseif, Sherif R. [1 ]
Sassani, Pejvak [1 ]
Franke, Ethan I. [1 ]
Nash, Steven D. [2 ]
Slutsky, Joel N. [3 ]
Baum, Neil H. [4 ]
Le Tu, Mai [5 ]
Galloway, Niall T. [6 ]
Pommerville, Peter J. [7 ]
Sutherland, Suzette E. [8 ]
机构
[1] Kaiser Permanente, Med Ctr, Reconstruct & Neurourol, Los Angeles, CA 90027 USA
[2] Kansas City Urol Care, Leawood, KS USA
[3] Urol Surg, Kankakee, IL USA
[4] Neil Baum Urol, New Orleans, LA USA
[5] CHUS Flairmont, Quebec City, PQ, Canada
[6] Emory Univ, Sch Med, Atlanta, GA USA
[7] Can Med Clin Res Inc, Victoria, BC, Canada
[8] Metropolitan Urol Specialists, Plymouth, MN USA
关键词
Urinary incontinence; Adjustable continence device; ACT; Recurrent incontinence; Female stress incontinence; FREE VAGINAL TAPE; MANAGEMENT;
D O I
10.1007/s00345-010-0589-4
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Treatment of recurrent stress incontinence after a failed surgical procedure is more complicated, and repeat surgeries have higher rates of complications and limited efficacy. We determined the technical feasibility, efficacy, adjustability, and safety of adjustable continence therapy device for treatment of moderate to severe recurrent urinary incontinence after failed surgical procedure. Female patients with moderate to severe recurrent stress urinary incontinence who had at least one prior surgical procedure for incontinence were enrolled. All patients underwent percutaneous placement of adjustable continence therapy (ACT) device (Uromedica, Plymouth, Minnesota). Baseline and regular follow-up tests to determine subjective and objective improvement were performed. A total of 89 patients have undergone implantation with 1-3 years of follow-up. Data are available on 77 patients at 1 year. Of the patients, 47% were dry at 1 year and 92% improved after 1-year follow-up. Stamey score improved from 2.25 to 0.94 at 1 year (P < 0.001). IQOL questionnaire scores improved from 33.9 to 71.6 at 1 year (P < 0.001). UDI scores reduced from 60.7 to 33.3 (P < 0.001) at 1 year. IIQ scores reduced from 57.0 to 21.6 (P < 0.001) at 1 year. Diary incontinence episodes per day improved from 8.1 to 3.9 (P < 0.001) at 1 year. Diary pads used per day improved from 4.3 to 1.9 (P < 0.001). Explantation was required in 21.7% of patients. The ACT device is an effective, simple, safe, and minimally invasive treatment for moderate to severe recurrent female stress urinary incontinence after failed surgical treatment.
引用
收藏
页码:249 / 253
页数:5
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