Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence



Título del documento: Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence
Revista: International braz j urol
Base de datos: PERIÓDICA
Número de sistema: 000296577
ISSN: 1677-5538
Autores: 1



Instituciones: 1Hospital Amaral Carvalho, Seccao de Urologia, Jau, Sao Paulo. Brasil
Año:
Periodo: Jul-Ago
Volumen: 30
Número: 4
Paginación: 307-312
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en inglés OBJECTIVE: Description and early results of a new urethral sling technique for treatment of postprostatectomy urinary incontinence, which combines efficacy, low cost and technical simplicity. MATERIALS AND METHODS: From May 2003 to April 2004, 30 patients with moderate or total urinary incontinence, following radical prostatectomy or endoscopic resection of the prostate, underwent the new technique. The technique is based on the placement of a longitudinal-shaped sling in the bulbar urethra, measuring 4 cm in length by 1.8 cm in width, made of Dacron or polypropylene mesh, fixed by 4 sutures on each side, with 2 sutures passed with Stamey-Pereira needle by retropubic approach and 2 by prepubic approach, which are then tied over the pubis. Pressure control was determined by interrupting the loss of infused water through a suprapubic cystostomy 60 cm from the pubis level. RESULTS: Pre-operative assessment excluded vesical instability, urethral stenosis and urinary infection. Suprapubic cystostomy was removed when the patient was able to satisfactorily void with urinary residue lower than 100 mL, which occurred in 29 of the 30 cases. In 2 cases, there was infection of the prosthesis, requiring its removal. In 3 cases, there was the need to adjust the sling (increasing the tension), due to failure of the urinary continence. Overall, 20 of 30 (66.7%) operated patients became totally continent, and did not require any kind of pads. Four of 30 (13.3%) patients achieved partial improvement, requiring 1 to 2 pads daily and 6 of 30 (20%) pat
Disciplinas: Medicina
Palabras clave: Cirugía,
Incontinencia urinaria,
Esfínter,
Vías urinarias,
Prótesis,
Implantes,
Técnicas quirúrgicas,
Hombres
Keyword: Medicine,
Surgery,
Urinary incontinence,
Sphincter,
Urinary tract,
Prostheses,
Implants,
Surgical techniques,
Men
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