Современное состояние проблемы недержания мочи после радикальной простатэктомии
Современное состояние проблемы недержания мочи после радикальной простатэктомии
Голубцова Е.Н., Томилов А.А., Велиев Е.И. Современное состояние проблемы недержания мочи после радикальной простатэктомии. Consilium Medicum. 2017; 19 (7): 8–14. DOI: 10.26442/2075-1753_19.7.8-14
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Golubtsova E.N., Tomilov A.A., Veliev E.I. The current state of the incontinence problem after radical prostatectomy. Consilium Medicum. 2017; 19 (7): 8–14. DOI: 10.26442/2075-1753_19.7.8-14
Современное состояние проблемы недержания мочи после радикальной простатэктомии
Голубцова Е.Н., Томилов А.А., Велиев Е.И. Современное состояние проблемы недержания мочи после радикальной простатэктомии. Consilium Medicum. 2017; 19 (7): 8–14. DOI: 10.26442/2075-1753_19.7.8-14
________________________________________________
Golubtsova E.N., Tomilov A.A., Veliev E.I. The current state of the incontinence problem after radical prostatectomy. Consilium Medicum. 2017; 19 (7): 8–14. DOI: 10.26442/2075-1753_19.7.8-14
Значительная часть пациентов после выполнения радикальной простатэктомии сталкиваются с проблемой недержания мочи (НМ). Факторы, влияющие на восстановление удержания мочи после радикальной простатэктомии, условно можно разделить на 3 группы: пред-, интра- и послеоперационные. Степень их влияния остается предметом для дискуссии. В подавляющем большинстве случаев континенция достигается в течение некоторого времени после перенесенной операции, от нескольких дней до 1 года. Обследование пациента с НМ должно быть комплексным. Ведущую роль среди консервативных мер коррекции инконтиненции играют упражнения для тренировки мышц тазового дна. В случае безуспешности терапевтических мероприятий целесообразно рассмотреть вопрос о хирургическом лечении. Пациенты, страдающие НМ легкой или в отдельных случаях средней степени тяжести, могут получать выгоды от минимально инвазивных методов хирургической коррекции, к числу которых относятся слинговые операции. Современным «золотым стандартом» в лечении пациентов, страдающих тяжелой степенью НМ, остается искусственный мочевой сфинктер AMS 800. Показания к имплантации слингов и искусственного мочевого сфинктера расширяются, что дает возможность излечения и для пациентов, перенесших ряд медицинских вмешательств. Все это позволяет обеспечить индивидуальный подход к каждому пациенту и оптимизировать качество жизни.
A significant proportion of patients after performing radical prostatectomy face the problem of urinary incontinence (UI). Factors affecting the recovery of urine retention after radical prostatectomy can be conditionally divided into 3 groups: pre-, intra- and postoperative. The degree of their influence remains a subject for discussion. In the vast majority of cases, the continence is reached for some time after the operation, from several days to 1 year. The examination of a patient with UI should be comprehensive. The leading role among conservative measures of correction of incontinence is played by exercises for training the muscles of the pelvic floor. In the case of unsuccessful therapeutic measures, it is advisable to consider the question of surgical treatment. Patients suffering from UI light or in some cases of moderate severity can benefit from minimally invasive surgical correction methods, including sling operations. The modern "gold standard" in the treatment of patients suffering from a severe degree of UI remains an artificial urinary sphincter AMS 800. Indications for the implantation of slings and artificial urinary sphincter expand, which provides a cure for patients who have undergone a number of medical interventions. All this allows to provide an individual approach to each patient and optimize the quality of life.
1. Magheli A, Jonas Busch J, Leva N et al. Comparison of surgical technique (Open vs. Laparoscopic) on pathological and long term functional outcomes following radical prostatectomy. BMC Urology 2014; 14: 18–24.
2. Ficarra V, Novara G, Rosen RC et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol 2012; 62: 405–17.
3. Abrams P, Andersson KE, Birder L et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn 2010; 29: 213–40.
4. Campodonico F, Manuputty EE, Campora S et al. Age is predictive of immediate postoperative urinary continence after radical retropubic prostatectomy. Urol Int 2014; 92 (3): 276–81.
5. Becker A, Tennstedt P, Hansen J et al. Functional and oncological outcomes of patients aged <50 years treated with radical prostatectomy for localised prostate cancer in a European population. BJU Int 2014; 114 (1): 38–45.
6. Gandaglia G, Suardi N, Gallina A et al. Preoperative erectile function represents a significant predictor of postoperative urinary continence recovery in patients treated with bilateral nerve sparing radical prostatectomy. J Urol 2012; 187 (2): 569–74.
7. Xu T, Wang X, Xia L et al. Robot-assisted prostatectomy in obese patients: how influential is obesity on operative outcomes? J Endourol 2015; 29 (2): 198–208.
8. Bayoud Y, de la Taille A, Ouzzane A et al. International Prostate Symptom Score is a predictive factor of lower urinary tract symptoms after radicalprostatectomy. Int J Urol 2015; 22 (3): 283–7.
9. Wallerstedt A, Carlsson S, Steineck G et al. Patient and tumour-related factors for prediction of urinary incontinence after radical prostatectomy. Scand J Urol 2013; 47 (4): 272–81.
10. Ko YH, Coelho RF, Chauhan S et al. Factors affecting return of continence 3 months after robotic-assisted radical prostatectomy: analysis from a large prospective data by a single surgeon. J Urol 2012; 187: 190–4.
11. Song C, Lee J, Hong JH et al. Urodynamic interpretation of changing bladder function and voiding pattern after radical prostatectomy: a long-term follow-up. BJU Int 2010; 106: 681–6.
12. Claudon P, Spie R, Bats M et al. Male stress urinary incontinence: medium-term results of treatment by sub-urethral bone anchored sling InVanceTM. Prog Urol 2011; 21 (9): 625–30.
13. Spie R, Claudon P, Raynal G et al. Radiotherapy influence, about results of the InVance(R) male sling in men with stress urinary incontinence. Prog Urol 2011; 21 (8): 549–53.
14. Romano SV, Huebner W, Rocha FT et al. A transobturator adjustable system for male incontinence: 30-month follow-up of a multicenter study. Braz J Urol 2014; 40: 781–9.
15. Cerruto MA, D'Elia С, Artibani W. Continence and complications rates after male slings as primary surgery for post-prostatectomy incontinence: A systematic review. Arch Ital Urol Androl 2013; 85 (2): 92–5.
16. Rehder P, Gozzi C. Transobturator sling suspension for male urinary incontinence including post-radical prostatectomy. Eur Urol 2007; 52 (3): 860–7.
17. Serra AC, Folkersma LR, Dom JL et al. Narb on AdVance/AdVance XP Transobturator Male Slings: Preoperative Degree of Incontinence as Predictor of Surgical Outcome. Urology 2013; 81: 1034–9.
18. Bauer RM, Gozzi C, Roosen A et al. Impact of the 'repositioning test' on postoperative outcome of retroluminar transobturator male slingimplantation. Urol Int 2013; 90 (3): 334–8.
19. Sturm RM, Guralnick ML, Stone AR et al. Comparison of Clinical Outcomes Between “Ideal” and “Nonideal” Transobturator Male Sling Patients for Treatment of Postprostatectomy Incontinence. Urology 2014; 83: 1186–9.
20. Pistolesi D, Zampa V, Gozzi С еt al. Could the Sling Position Influence the Clinical Outcome in Male Patients Treated for Urinary Incontinence? A Magnetic Resonance Imaging Study With a 3 Tesla System. Urology 2014; 83: 471–6.
21. Kowalik CG, DeLong JM, Mourtzinos AP. The advance transobturator male sling for post-prostatectomy incontinence: subjective and objective outcomes with 3 years follow up. Neurourol Urodyn 2015; 34 (3): 251–4.
22. Zuckerman JM, Edwards B, Henderson K et al. Extended Outcomes in the Treatment of Male Stress Urinary Incontinence With a Transobturator Sling. Urology 2014; 83: 939–45.
23. Hall M, Polland A, Weissbart S et al. Prognostic value of postoperative urinary retention after male sling insertion. Can J Urol 2014; 21 (4): 7344–9.
24. Bauer RM, Kretschmer A, Stief CG et al. AdVance and AdVance XP slings for the treatment of post-prostatectomy incontinence. World J Urol 2015; 33 (1): 145–50.
25. Martinez EJ, Zuckerman JM, Henderson K et al. Evaluation of Salvage Male Transobturator Sling Placement Following Recurrent Stress Urinary Incontinence After Failed Transobturator Sling. Urology 2015; 85: 478–82.
26. Holm HV, Fossa SD, Hedlund H et al. Severe postprostatectomy incontinence: Is there an association between preoperative urodynamic findings and outcome of incontinence surgery? Scand J Urol 2015; 49 (3): 250–9.
27. Aa F, Drake MJ, Kasyan GR et al. The Artificial Urinary Sphincter After a Quarter of a Century: A Critical Systematic Review of Its Use in Male Non-neurogenic Incontinence. Eur Urol 2013; 63: 681–9.
28. Linder BJ, Rivera ME, Ziegelmann MJ et al. Long-term Outcomes Following Artificial Urinary Sphincter Placement: An Analysis of 1082 Cases at Mayo Clinic. Urology 2015; 86: 602–7.
29. Lеon P, Chartier-Kastler E, Rouprкt M еt al. Long-term functional outcomes after artificial urinary sphincter implantation in men with stress urinary incontinence. BJU Int 2015; 115: 951–7.
30. Gulpinar O, Suer E, Gokce MI et al. Functional Outcomes and Long-term Durability of Artificial Urinary Sphincter Application: Review of 56 Patients With Long-term Follow-up Korean. J Urol 2013; 54: 373–6.
31. Singla N, Siegel JA, Simhan J et al. Does Pressure Regulating Balloon Location Make a Difference in Functional Outcomes of Artificial Urinary Sphincter? J Urol 2015; 194 (1): 202–6.
32. Chung PH, Morey AF, Tausch TJ et al. High Submuscular Placement of Urologic Prosthetic Balloons and Reservoirs: 2-Year Experience and Patient-reported Outcomes. Urology 2014; 84: 1540–5.
33. Simhan J, Morey AF, Zhao LC et al. Decreasing need for artificial urinary sphincter revision surgery by precise cuff sizing in men with spongiosal atrophy. J Urol 2014; 192 (3): 798–803.
34. Lai HH, Boone TB. The surgical learning curve of artificial urinary sphincter implantation: implications for prosthetic training and referral. J Urol 2013; 189 (4): 1437–43.
35. Sandhu JS. Artificial Urinary Sphincter: The Workhorse for Treatment of Male Stress Urinary Incontinence. Eur Urol 2013; 63: 690–2.
36. McGeady JB, McAninch JW, Truesdale MD et al. Artificial Urinary Sphincter Placement in Compromised Urethras and Survival: A Comparison of Virgin, Radiated and Reoperative Cases. J Urol 2014; 192 (6): 1756–61.
37. Sathianathen NJ, McGuigan SM, Moon DA. Outcomes of artificial urinary sphincter implantation in the irradiated patient. BJU Int 2014; 113: 636–41.
38. Selph JP, Madden-Fuentes R, Peterson AC et al. LentzLong-term Artificial Urinary Sphincter Outcomes Following a Prior Rectourethral Fistula Repair. Urology 2015; 86: 608–12.
39. De Cogain MR, Elliott DS. The impact of an antibiotic coating on the artificial urinary sphincter infection rate. J Urol 2013; 190 (1): 113–7.
40. Linder BJ, Piotrowski JT, Ziegelmann MJ et al. Perioperative Complications following Artificial Urinary Sphincter Placement. J Urol 2015; 194 (3): 716–20.
41. Brant WO, Erickson BA, Elliott SP et al. Risk Factors for Erosion of Artificial Urinary Sphincters: A Multicenter Prospective Study. Urology 2014; 84 (4): 934–8.
________________________________________________
1. Magheli A, Jonas Busch J, Leva N et al. Comparison of surgical technique (Open vs. Laparoscopic) on pathological and long term functional outcomes following radical prostatectomy. BMC Urology 2014; 14: 18–24.
2. Ficarra V, Novara G, Rosen RC et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol 2012; 62: 405–17.
3. Abrams P, Andersson KE, Birder L et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn 2010; 29: 213–40.
4. Campodonico F, Manuputty EE, Campora S et al. Age is predictive of immediate postoperative urinary continence after radical retropubic prostatectomy. Urol Int 2014; 92 (3): 276–81.
5. Becker A, Tennstedt P, Hansen J et al. Functional and oncological outcomes of patients aged <50 years treated with radical prostatectomy for localised prostate cancer in a European population. BJU Int 2014; 114 (1): 38–45.
6. Gandaglia G, Suardi N, Gallina A et al. Preoperative erectile function represents a significant predictor of postoperative urinary continence recovery in patients treated with bilateral nerve sparing radical prostatectomy. J Urol 2012; 187 (2): 569–74.
7. Xu T, Wang X, Xia L et al. Robot-assisted prostatectomy in obese patients: how influential is obesity on operative outcomes? J Endourol 2015; 29 (2): 198–208.
8. Bayoud Y, de la Taille A, Ouzzane A et al. International Prostate Symptom Score is a predictive factor of lower urinary tract symptoms after radicalprostatectomy. Int J Urol 2015; 22 (3): 283–7.
9. Wallerstedt A, Carlsson S, Steineck G et al. Patient and tumour-related factors for prediction of urinary incontinence after radical prostatectomy. Scand J Urol 2013; 47 (4): 272–81.
10. Ko YH, Coelho RF, Chauhan S et al. Factors affecting return of continence 3 months after robotic-assisted radical prostatectomy: analysis from a large prospective data by a single surgeon. J Urol 2012; 187: 190–4.
11. Song C, Lee J, Hong JH et al. Urodynamic interpretation of changing bladder function and voiding pattern after radical prostatectomy: a long-term follow-up. BJU Int 2010; 106: 681–6.
12. Claudon P, Spie R, Bats M et al. Male stress urinary incontinence: medium-term results of treatment by sub-urethral bone anchored sling InVanceTM. Prog Urol 2011; 21 (9): 625–30.
13. Spie R, Claudon P, Raynal G et al. Radiotherapy influence, about results of the InVance(R) male sling in men with stress urinary incontinence. Prog Urol 2011; 21 (8): 549–53.
14. Romano SV, Huebner W, Rocha FT et al. A transobturator adjustable system for male incontinence: 30-month follow-up of a multicenter study. Braz J Urol 2014; 40: 781–9.
15. Cerruto MA, D'Elia С, Artibani W. Continence and complications rates after male slings as primary surgery for post-prostatectomy incontinence: A systematic review. Arch Ital Urol Androl 2013; 85 (2): 92–5.
16. Rehder P, Gozzi C. Transobturator sling suspension for male urinary incontinence including post-radical prostatectomy. Eur Urol 2007; 52 (3): 860–7.
17. Serra AC, Folkersma LR, Dom JL et al. Narb on AdVance/AdVance XP Transobturator Male Slings: Preoperative Degree of Incontinence as Predictor of Surgical Outcome. Urology 2013; 81: 1034–9.
18. Bauer RM, Gozzi C, Roosen A et al. Impact of the 'repositioning test' on postoperative outcome of retroluminar transobturator male slingimplantation. Urol Int 2013; 90 (3): 334–8.
19. Sturm RM, Guralnick ML, Stone AR et al. Comparison of Clinical Outcomes Between “Ideal” and “Nonideal” Transobturator Male Sling Patients for Treatment of Postprostatectomy Incontinence. Urology 2014; 83: 1186–9.
20. Pistolesi D, Zampa V, Gozzi С еt al. Could the Sling Position Influence the Clinical Outcome in Male Patients Treated for Urinary Incontinence? A Magnetic Resonance Imaging Study With a 3 Tesla System. Urology 2014; 83: 471–6.
21. Kowalik CG, DeLong JM, Mourtzinos AP. The advance transobturator male sling for post-prostatectomy incontinence: subjective and objective outcomes with 3 years follow up. Neurourol Urodyn 2015; 34 (3): 251–4.
22. Zuckerman JM, Edwards B, Henderson K et al. Extended Outcomes in the Treatment of Male Stress Urinary Incontinence With a Transobturator Sling. Urology 2014; 83: 939–45.
23. Hall M, Polland A, Weissbart S et al. Prognostic value of postoperative urinary retention after male sling insertion. Can J Urol 2014; 21 (4): 7344–9.
24. Bauer RM, Kretschmer A, Stief CG et al. AdVance and AdVance XP slings for the treatment of post-prostatectomy incontinence. World J Urol 2015; 33 (1): 145–50.
25. Martinez EJ, Zuckerman JM, Henderson K et al. Evaluation of Salvage Male Transobturator Sling Placement Following Recurrent Stress Urinary Incontinence After Failed Transobturator Sling. Urology 2015; 85: 478–82.
26. Holm HV, Fossa SD, Hedlund H et al. Severe postprostatectomy incontinence: Is there an association between preoperative urodynamic findings and outcome of incontinence surgery? Scand J Urol 2015; 49 (3): 250–9.
27. Aa F, Drake MJ, Kasyan GR et al. The Artificial Urinary Sphincter After a Quarter of a Century: A Critical Systematic Review of Its Use in Male Non-neurogenic Incontinence. Eur Urol 2013; 63: 681–9.
28. Linder BJ, Rivera ME, Ziegelmann MJ et al. Long-term Outcomes Following Artificial Urinary Sphincter Placement: An Analysis of 1082 Cases at Mayo Clinic. Urology 2015; 86: 602–7.
29. Lеon P, Chartier-Kastler E, Rouprкt M еt al. Long-term functional outcomes after artificial urinary sphincter implantation in men with stress urinary incontinence. BJU Int 2015; 115: 951–7.
30. Gulpinar O, Suer E, Gokce MI et al. Functional Outcomes and Long-term Durability of Artificial Urinary Sphincter Application: Review of 56 Patients With Long-term Follow-up Korean. J Urol 2013; 54: 373–6.
31. Singla N, Siegel JA, Simhan J et al. Does Pressure Regulating Balloon Location Make a Difference in Functional Outcomes of Artificial Urinary Sphincter? J Urol 2015; 194 (1): 202–6.
32. Chung PH, Morey AF, Tausch TJ et al. High Submuscular Placement of Urologic Prosthetic Balloons and Reservoirs: 2-Year Experience and Patient-reported Outcomes. Urology 2014; 84: 1540–5.
33. Simhan J, Morey AF, Zhao LC et al. Decreasing need for artificial urinary sphincter revision surgery by precise cuff sizing in men with spongiosal atrophy. J Urol 2014; 192 (3): 798–803.
34. Lai HH, Boone TB. The surgical learning curve of artificial urinary sphincter implantation: implications for prosthetic training and referral. J Urol 2013; 189 (4): 1437–43.
35. Sandhu JS. Artificial Urinary Sphincter: The Workhorse for Treatment of Male Stress Urinary Incontinence. Eur Urol 2013; 63: 690–2.
36. McGeady JB, McAninch JW, Truesdale MD et al. Artificial Urinary Sphincter Placement in Compromised Urethras and Survival: A Comparison of Virgin, Radiated and Reoperative Cases. J Urol 2014; 192 (6): 1756–61.
37. Sathianathen NJ, McGuigan SM, Moon DA. Outcomes of artificial urinary sphincter implantation in the irradiated patient. BJU Int 2014; 113: 636–41.
38. Selph JP, Madden-Fuentes R, Peterson AC et al. LentzLong-term Artificial Urinary Sphincter Outcomes Following a Prior Rectourethral Fistula Repair. Urology 2015; 86: 608–12.
39. De Cogain MR, Elliott DS. The impact of an antibiotic coating on the artificial urinary sphincter infection rate. J Urol 2013; 190 (1): 113–7.
40. Linder BJ, Piotrowski JT, Ziegelmann MJ et al. Perioperative Complications following Artificial Urinary Sphincter Placement. J Urol 2015; 194 (3): 716–20.
41. Brant WO, Erickson BA, Elliott SP et al. Risk Factors for Erosion of Artificial Urinary Sphincters: A Multicenter Prospective Study. Urology 2014; 84 (4): 934–8.
Авторы
Е.Н.Голубцова*1,2, А.А.Томилов2, Е.И.Велиев1,2
1 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1;
2 ГБУЗ «ГКБ им. С.П.Боткина» Департамента здравоохранения г. Москвы. 125284, Россия, Москва, 2-й Боткинский пр-д, д. 5 *engolubtsova@yandex.ru
________________________________________________
E.N.Golubtsova*1,2, A.A.Tomilov2, E.I.Veliev1,2
1 Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 125993, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1;
2 S.P.Botkin City Clinical Hospital of the Department of Health of Moscow. 125284, Russian Federation, Moscow, 2-i Botkinskii proezd, d. 5 *engolubtsova@yandex.ru