Bandelette sous-urétrale et transobturatrice TOMS™ chez l’homme : indication, technique et résultats

Abstract

Incontinence post-prostatectomy remains a problem and in order to minimize surgical morbidity and costs, minimal invasive procedures have been proposed. The authors present the TOMS TM new procedure. A median perineal incision exposes the space between each ischiocavernous muscle and the bulbospongiosus. The trans-obturator puncture is an outside-inside or inside-outside, then the sling is applied on the uretra with tension. No postoperative complications were reported except minimal pain and one retention. The median number of pads per day decreased significantly from 4 pads before surgery to 0,9 after surgery, and half of the patients were completely dry. The SF 36 and ICIQ continence and quality of life scores improvement were respectively 50 and 54 % with one year follow-up. The TOMS TM is an attractive simple well tolerated sling technique for moderate or minor post-prostatectomy stress incontinence.