인공요도괄약근 시술의 20년 경험
Twenty Years of Experience with Artificial Urinary Sphincter Implantation
오철영, 이승환, 정현진, 임영재, 마상열,
소속 상세정보
오철영 ( Oh Cheol-Young )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
이승환 ( Lee Seung-Hwan )
연세대학교 의과대학 비뇨기과학교실
정현진 ( Jung Hyun-Jin )
연세대학교 의과대학 비뇨기과학교실
임영재 ( Im Young-Jae )
연세대학교 의과대학 비뇨기과학교실
마상열 ( Mah Sang-Yol )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
KMID : 0358320080490060520
Abstract
Purpose:The efficacy of the artificial urinary sphincter(AUS) in treating sphincteric incontinence has been clearly demonstrated. We report on 20 years of experience using artificial sphincter implantation at a single institute.
Material and Methods :The follow-up data for 37 patients who received AUS(AMS 800TM) implantation between 1987 and 2006 at Yonsei University were available for this study. We investigated various components of the medical records, such as the number of pads used per day, results of pre-operative urodynamic studies, operative and post-operative complications, and revision rate.
Results:Mean patient age was 35.6 years(range 15-64 years), and mean follow-up duration was 12.4 years(range 1.4-19.8 years). Of the 37 patients, 21 had neurogenic bladder, and 9 had traumatic injury. Other causes of incontinence included post-operative complications(4 patients) and congenital anomalies(3 patients). The cuffs were placed were in the bladder necks of 21 patients and in the bulbous urethrae of 16 patients. The average number of pads used daily decreased significantly from 6.2 to 1.2 after the operation, and 27 patients(72.9%) were able to maintain ’dry-up status’ (number of pads used≤1). A total of 32 artificial sphincters remained in place(86.4% survival rate), with 8 revisions(21.6%) required secondary to infection, mechanical failure, or urethral stone.
Conclusion: AUS implantation is a safe and durable treatment for urinary incontinence in patients with intrinsic sphincter deficiency from various underlying diseases.
키워드
Bladder;Urinary incontinence; Artificial urinary;sphincter
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