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BONE ANCHORED SLING FOR THE TREATMENT OF POST-PROSTATECTOMY INCONTINENCE

2001; Lippincott Williams & Wilkins; Volume: 165; Issue: 1 Linguagem: Inglês

10.1097/00005392-200101000-00018

1527-3792

Shahar Madjar, Karny Jacoby, Claudio Giberti, Moshe Wald, Sarel Halachmi, Elias Issaq, Boaz Moskovitz, M. Beyar, Ofer Nativ,

Reconstructive Surgery and Microvascular Techniques

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jan 2001BONE ANCHORED SLING FOR THE TREATMENT OF POST-PROSTATECTOMY INCONTINENCE S. MADJAR, K. JACOBY, C. GIBERTI, M. WALD, S. HALACHMI, E. ISSAQ, B. MOSKOVITZ, M. BEYAR, and O. NATIV S. MADJARS. MADJAR , K. JACOBYK. JACOBY , C. GIBERTIC. GIBERTI , M. WALDM. WALD , S. HALACHMIS. HALACHMI , E. ISSAQE. ISSAQ , B. MOSKOVITZB. MOSKOVITZ , M. BEYARM. BEYAR , and O. NATIVO. NATIV View All Author Informationhttps://doi.org/10.1097/00005392-200101000-00018AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: This ongoing study evaluates the safety and efficacy of a new minimally invasive sling procedure for treating post-prostatectomy incontinence. Materials and Methods: A total of 16 men 56 to 74 years old (mean age 67) underwent the procedure using the Straight-In† Influence, Inc., San Francisco, California. bone anchoring system. Time after prostatectomy was 1.5 to 5 years (mean 2.5). Of the 16 patients 14 had urodynamically confirmed stress urinary incontinence, while 2 had mixed incontinence with stress incontinence and detrusor instability. The procedure is performed with the patient in the lithotomy position using a perineal approach. Four miniature bone screws with pre-attached pairs of No. 1 polypropylene sutures are placed directly into the medial aspect of the inferior rami of the pubic bone. A pair of bone anchors is placed just below the symphysis on each side, and the second pair is inserted 3 to 4 cm. lower. To support the bulbar urethra a gelatin coated polyethylene terephthalate trapezoid shaped sling or cadaveric fascia lata is tied to the pubic bone using the 4 pairs of sutures attached to the bone anchors. Urethral resistance is increased to 30 to 50 cm. water above baseline pressure. Results: Followup was 4 to 20 months (mean 12.2). Of the 14 men with the preoperative urodynamic diagnosis of genuine stress incontinence 12 were cured of incontinence, defined as subjectively dry with no or only 1 pad used daily for security without any episode of leakage, while 2 were improved subjectively with a decrease of 50% or more in pads daily. Two other patients with the preoperative diagnosis of mixed urinary incontinence were improved. Postoperatively urodynamic study in these patients revealed resolved stress incontinence but persistent urge urinary incontinence. They responded to anticholinergics and are completely dry. Intraoperative and postoperative complications were minimal with no erosion, infection or osseous complications. Conclusions: This new minimally invasive male sling procedure is safe and efficacious. Adjusting sling tension by measuring urethral resistance results in a low rate of over correction and failure. 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Crossref, Medline, Google Scholar From the Bnai-Zion Medical Center, Haifa, Israel, Northwest Hospital, Seattle, Washington, and San Paolo Hospital, Savona, Italy© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited bySandhu J (2014) Treatment Options for Post-Prostatectomy IncontinenceUrology Practice, VOL. 1, NO. 4, (194-197), Online publication date: 1-Nov-2014.Poon S, Silberstein J, Savage C, Maschino A, Lowrance W and Sandhu J (2012) Surgical Practice Patterns for Male Urinary Incontinence: Analysis of Case Logs from Certifying American UrologistsJournal of Urology, VOL. 188, NO. 1, (205-210), Online publication date: 1-Jul-2012.Wadie B (2010) Retropubic Bulbourethral Sling for Post-Prostatectomy Male Incontinence: 2-Year FollowupJournal of Urology, VOL. 184, NO. 6, (2446-2451), Online publication date: 1-Dec-2010.Dean G and Kunkle D (2009) Outpatient Perineal Sling in Adolescent Boys With Neurogenic IncontinenceJournal of Urology, VOL. 182, NO. 4S, (1792-1796), Online publication date: 1-Oct-2009.Inci K, Ergen A, Bilen C, Yuksel S and Ozen H (2007) A New Device for the Treatment of Post-Prostatectomy Incontinence: Adjustable Perineal Male SlingJournal of Urology, VOL. 179, NO. 2, (605-609), Online publication date: 1-Feb-2008.Migliari R, Pistolesi D, Leone P, Viola D and Trovarelli S (2018) Male Bulbourethral Sling After Radical Prostatectomy: Intermediate Outcomes at 2 to 4-Year FollowupJournal of Urology, VOL. 176, NO. 5, (2114-2118), Online publication date: 1-Nov-2006.WESTNEY O, BEVAN-THOMAS R, PALMER J, CESPEDES R and McGUIRE E (2018) TRANSURETHRAL COLLAGEN INJECTIONS FOR MALE INTRINSIC SPHINCTER DEFICIENCY: THE UNIVERSITY OF TEXAS-HOUSTON EXPERIENCEJournal of Urology, VOL. 174, NO. 3, (994-997), Online publication date: 1-Sep-2005.Hakim J and Gignac M (2018) RE: EROSION OF A MALE POLYPROPYLENE SLINGJournal of Urology, VOL. 174, NO. 1, (397-397), Online publication date: 1-Jul-2005.STERN J, CLEMENS J, TIPLITSKY S, MATSCHKE H, JAIN P and SCHAEFFER A (2018) LONG-TERM RESULTS OF THE BULBOURETHRAL SLING PROCEDUREJournal of Urology, VOL. 173, NO. 5, (1654-1656), Online publication date: 1-May-2005.CASTLE E, ANDREWS P, ITANO N, NOVICKI D, SWANSON S and FERRIGNI R (2018) THE MALE SLING FOR POST-PROSTATECTOMY INCONTINENCE: MEAN FOLLOWUP OF 18 MONTHSJournal of Urology, VOL. 173, NO. 5, (1657-1660), Online publication date: 1-May-2005.RHEE E (2018) TECHNIQUE FOR CONCOMITANT IMPLANTATION OF THE PENILE PROSTHESIS WITH THE MALE SLINGJournal of Urology, VOL. 173, NO. 3, (925-927), Online publication date: 1-Mar-2005.SAMLI M and SINGLA A (2018) ABSORBABLE VERSUS NONABSORBABLE GRAFT: OUTCOME OF BONE ANCHORED MALE SLING FOR POST-RADICAL PROSTATECTOMY INCONTINENCEJournal of Urology, VOL. 173, NO. 2, (499-502), Online publication date: 1-Feb-2005.DIKRANIAN A, CHANG J, RHEE E and ABOSEIF S (2018) THE MALE PERINEAL SLING: COMPARISON OF SLING MATERIALSJournal of Urology, VOL. 172, NO. 2, (608-610), Online publication date: 1-Aug-2004.ULLRICH N and COMITER C (2018) THE MALE SLING FOR STRESS URINARY INCONTINENCE: URODYNAMIC AND SUBJECTIVE ASSESSMENTJournal of Urology, VOL. 172, NO. 1, (204-206), Online publication date: 1-Jul-2004.JOHN H (2018) Bulbourethral Composite Suspension: A New Operative Technique for Post-Prostatectomy Incontinence.Journal of Urology, VOL. 171, NO. 5, (1866-1870), Online publication date: 1-May-2004.Comiter C (2018) THE MALE SLING FOR STRESS URINARY INCONTINENCE: A PROSPECTIVE STUDYJournal of Urology, VOL. 167, NO. 2 Part 1, (597-601), Online publication date: 1-Feb-2002.MADJAR S, RAZ S and GOUSSE A (2018) FIXED AND DYNAMIC URETHRAL COMPRESSION FOR THE TREATMENT OF POST-PROSTATECTOMY URINARY INCONTINENCE: IS HISTORY REPEATING ITSELF?Journal of Urology, VOL. 166, NO. 2, (411-415), Online publication date: 1-Aug-2001. Volume 165Issue 1January 2001Page: 72-76 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsprostatebone and bonesurinary incontinenceprostatectomyMetricsAuthor Information S. MADJAR More articles by this author K. JACOBY Financial and/or other relationship with Influence, Inc. More articles by this author C. GIBERTI More articles by this author M. WALD More articles by this author S. HALACHMI More articles by this author E. ISSAQ More articles by this author B. MOSKOVITZ More articles by this author M. BEYAR Financial and/or other relationship with Influence, Inc. More articles by this author O. NATIV More articles by this author Expand All Advertisement PDF downloadLoading ...