THE MALE SLING FOR STRESS URINARY INCONTINENCE: A PROSPECTIVE STUDY
2002; Lippincott Williams & Wilkins; Volume: 167; Issue: 2 Part 1 Linguagem: Inglês
10.1016/s0022-5347(01)69092-x
ISSN1527-3792
Autores Tópico(s)Urinary Tract Infections Management
ResumoNo AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Feb 2002THE MALE SLING FOR STRESS URINARY INCONTINENCE: A PROSPECTIVE STUDY Craig V. Comiter Craig V. ComiterCraig V. Comiter View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)69092-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: This is a report of a prospective study of the male sling for treating stress urinary incontinence. Materials and Methods: A total of 21 men underwent sling surgery. There were 2 titanium screws loaded with polypropylene suture placed in each descending pubic ramus through a 3.5 cm. perineal incision at the level of the bulbar urethra. A polypropylene mesh was placed over the urethra and tied to the bone anchors, adjusting sling tension to a compression pressure of 60 cm. water. Followup was done with the incontinence section of the University of California, Los Angeles/RAND Prostate Cancer Index. Results: Mean followup was 12 months (range 5 to 21). Overall, incontinence was cured in 16 (76%) patients, substantially improved (stress urinary incontinence very small or small problem, 1 pad daily) in 3 (14%), somewhat improved (moderate problem—2 pads) in 1 and procedure failed (no improvement) in 1 (5%). The patients with stress urinary incontinence after undergoing transurethral prostatectomy were cured, as was the individual with myelomeningocele. Of the 18 patients with stress urinary incontinence after radical prostatectomy 13 were cured, including 1 of 2 who underwent previous artificial urinary sphincter placement and 2 of 3 adjuvant radiation. There was significant improvement in each survey question, and the total score improved from a mean plus or minus standard deviation of 65 ± 11 preoperatively to 397 ± 29 postoperatively (p <0.001). There was no retention, infection, erosion or de novo voiding dysfunction. Conclusions: This minimally invasive sling surgery has not been associated with any significant complication, and early results compare favorably with artificial urinary sphincter. By compressing only the ventral urethra the risk of urethral erosion and atrophy is reduced. Prior radiation or artificial urinary sphincter does not appear to be a contraindication to sling surgery. References 1 : Questionnaire based results of the bulbourethral sling procedure. J Urol1999; 162: 1972. Link, Google Scholar 2 : Bone anchored sling for the treatment of post-prostatectomy incontinence. J Urol2001; 165: 72. Link, Google Scholar 3 : Male slings for post-prostatectomy incontinence. Tech Urol2001; 7: 176. Medline, Google Scholar 4 : Suburethral sling for male urinary incontinence. Infect Urol2001; 14: 10. Google Scholar 5 : Leak-point pressures. Urol Clin North Am1996; 23: 253. 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Volume 167Issue 2 Part 1February 2002Page: 597-601 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsprostatectomyurethraurinary incontinence, stressMetricsAuthor Information Craig V. Comiter More articles by this author Expand All Advertisement PDF downloadLoading ...
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