Resultados del esfínter urinario artificial en incontinencia urinaria post-prostatectomía radical. Revisión narrativa
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v81i6.826Palabras clave:
Incontinencia urinaria de esfuerzo, incontinencia urinaria, prostatectomía, esfínter urinario artificial, prostatectomía radical, complicaciones, resultadosResumen
La incontinencia urinaria posterior a la prostatectomía radical es una complicación común que puede afectar negativamente la calidad de vida de los pacientes. Los tratamientos incluyen opciones médicas y quirúrgicas, siendo la inserción de un esfínter uretral artificial (EUA) el estándar de oro. El objetivo de esta revisión narrativa es evaluar los resultados de la implantación de un esfínter urinario artificial para la incontinencia urinaria desarrollada después de una prostatectomía radical con y sin radiación, en términos de continencia urinaria y complicaciones. La búsqueda en MEDLINE y Scopus arrojó 477 artículos. Se incluyeron un total de once artículos para el análisis cualitativo. Se incluyeron un total de 707 hombres que cumplieron con los criterios de inclusión. El 22,6% de los hombres (160 pacientes) recibieron radioterapia pélvica externa previa a la implantación del esfínter urinario artificial. La tasa general de éxito de la continencia se definió por el uso de pañales. Algunos autores informaron una tasa de éxito de 0 pañales por día (PPD) o ≤1 PPD en el último seguimiento. Las complicaciones incluyeron atrofia uretral, falla mecánica, revisión y/o remoción del dispositivo, infección y erosión. Se deben realizar más estudios prospectivos para aclarar los conceptos de continencia después de la colocación de un EUA y las complicaciones a largo plazo.
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