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拉尔普后SUI和ED的管理 - - 是什么,我们应该做什么?
Thairo A Pereira1, Jacob O Rust1, Helen L Bernie2
1Department of Urology, Indiana University, 11725 North Illinois Street - Carmel, Indianapolis, IN, IN - 46032, United States of America.
后机器人前列腺切除术,管理压力尿失禁 (SUI) 和勃起功能障碍 (ED) 涉及患者病史和量身定制的治疗. 早期的骨盆底治疗和阴茎康复 (PR) 是关键的,在SUI中使用和人工尿道关.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
- 康复医学 康复医学 康复医学
背景情况:
- 最少侵入性的激进性前列腺切除术,如机器人辅助腹腔镜前列腺切除术 (RALP),可能会对男性禁欲和勃起功能 (EF) 产生重大影响.
- 这些术后并发症会严重损害患者的生活质量.
- 在RALP后,应激性尿失禁 (SUI) 和勃起功能障碍 (ED) 的有效管理策略至关重要.
研究的目的:
- 批判性地审查RALP后男性SUI和ED的当前治疗选择.
- 探索新出现的趋势和未来的方向在管理和预防这些前列腺切除术后的条件.
- 为临床医生和研究人员提供基于证据的概述.
主要方法:
- 对RALP后SUI和ED的现有治疗选择进行系统的文献综述.
- 分析关于阴茎康复 (PR) 策略的当前证据及其对EF的影响.
- 对SUI进行手术干预的评估,包括和人工泌尿器.
- 讨论新兴趋势和未来的研究重点.
主要成果:
- 患者病史和症状严重程度对于SUI和ED的治疗决策至关重要.
- 阴茎康复 (PR) 显示了缓解治疗后ED的潜力,但对最佳方案缺乏共识.
- 对于所有RALP患者,建议对SUI进行手术前咨询和早期的骨盆底物理治疗.
- 固定/可调节的子对轻度至中度的SUI有效;人工尿道关节是中度至重度SUI的黄金标准.
- 由于患者因素,合规性和成本,EF恢复受到挑战,没有标准化的PR方法.
结论:
- 考虑到患者病史和症状影响,量身定制的治疗方法对于管理RALP后的SUI和ED至关重要.
- 骨盆地物理治疗和PR策略应整合到患者护理途径中.
- 需要进一步的研究来优化治疗方法,建立标准化的公关协议,并改善患者的遵从性,以获得更好的结果.
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