Proposal of a new way to evaluate the external sphincter function prior male sling surgey



Título del documento: Proposal of a new way to evaluate the external sphincter function prior male sling surgey
Revista: International braz j urol
Base de datos: PERIÓDICA
Número de sistema: 000434810
ISSN: 1677-5538
Autors: 1
1
1
1
2
1
Institucions: 1Universidade Estadual de Campinas, Departamento de Cirurgia Urologica, Campinas, Sao Paulo. Brasil
2Ark-La-Tex Urology, Department of Urology, Shreveport, Luisiana. Estados Unidos de América
Any:
Període: Mar-Abr
Volum: 45
Número: 2
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés Objective: To propose a new way to objectively evaluate the external sphincter function prior to male sling surgery. Materials and Methods: We evaluated the pre-operative sphincter function throughout sphincter pressure at rest (SPAR) and sphincter pressure under contraction (SPUC) obtained throughout urethral profilometry profile (UPP) of 10 consecutive patients (age range, 54-79 years) treated with the retrourethral transobturator sling (RTS) for stress urinary incontinence (SUI) because of prostate surgery. The primary endpoint for surgery success rate was post-operative pad weight test. This was correlated to pre-operative pad test, RT, SPAR and SPUC. Post-operatively patients were classified as continent (no pad use) and those who still were incontinent. Results: Mean SPUC in the continent and incontinent group was respectively 188 + 8.8 (median 185.1, range 181 to 201) and 96.9 + 49.4 (median 109.9, range 35.6 to 163.6) (P = 0.008). Mean 24-hour pad test was 151 + 84.2gm (median 140, range 80 to 245) and 973 + 337.1gm (median 1940, range 550 to 1200) in post-operative continent and incontinent groups respectively (P = 0.008). The repositioning test (RT) was positive in all continent patients except one. The RT was also positive in three incontinence patients (false positive). In all post-operative continent patients SPUC was higher than 180cmH2O and pre-operative pad test was less than 245gm. Conclusions: SPUC seems to be a way for optimizing the sphincter evaluation as well to become a useful tool for patient selection prior to RTS surgery
Disciplines Medicina
Paraules clau: Urología,
Cirugía,
Prostatectomía,
Resección transuretral,
Incontinencia urinaria
Keyword: Urology,
Surgery,
Urinary incontinence,
Prostatectomy,
Transurethral resection
Text complet: Texto completo (Ver HTML) Texto completo (Ver PDF)