尿路转移作为最后的选择,在人造尿路部失败和Iatrogenic破坏了膀出口后
Henriette Veiby Holm1, Nicolaas Lumen2, Tim Alexander Ludwig3
1Department of Urology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
Neurourology and urodynamics
|February 17, 2025
概括
盆腔辐射或废除疗法 (RT/AT) 增加了人造泌尿关节 (AUS) 衰竭和尿路转移 (UD) 的风险,在被摧毁的膀出口 (DBO) 患者中. 复杂的病例与失败的重建往往导致UD改善生活质量.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 重建性手术是一种重建性手术.
- 在瘤学瘤学.
背景情况:
- 催化剂破坏性膀出口 (DBO) 带来了重大的重建挑战.
- 人工尿道 (AUS) 是一种常见的治疗失禁,但可能会失败.
- 尿路转移 (UD) 是一个难治的DBO和AUS失败的救援选项.
研究的目的:
- 为了确定AUS失败的风险因素以及随后在患有阳性DBO的患者中需要UD.
- 为了比较治疗骨盆辐射/废除疗法 (RT/AT) 和单独手术治疗的患者之间的结果.
- 在这个患者群体中描述与UD相关的功能结果和并发症.
主要方法:
- 在2008年至2020年期间,对34名在AUS失败后需要UD的患者进行了回顾性多中心研究.
- 患者被分为两组:RT/AT±手术 (G1) 和单独的手术 (G2).
- 收集了关于人口统计,并发病,先前治疗,重建尝试和UD类型的数据.
主要成果:
- 大多数患者 (88.2%) 首要诊断为前列腺癌.
- RT/AT±手术 (G1) 包括27名患者,而单独手术 (G2) 包括7名患者.
- 虽然G1的第一次并发症时间较长,但G1的第一次并发症到UD的时间也较短,这表明最初的表现或治疗反应更复杂.
结论:
- 盆腔RT / AT,复杂的初级手术治疗,AUS并发症和未成功的重建导致无法挽救的DBO.
- 对于DBO和失败的AUS患者来说,UD通常是最后的选择,代表了改善生活质量的权衡.
- 了解这些风险因素对于管理严重膀出口问题的患者至关重要.
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