Manejo de la incontinencia urinaria masculina. Experiencia de un cirujano

Abstract

ObjectiveTo analyze the methods available for the management of male urinary incontinence and to evaluate their response in a number of selected patients. MethodsA retrospective analysis of male patients with urinary incontinence due to sphincter incompetence treated with slings (AdVance, Argus) and artificial urinary sphincter, from 2005 to 2010 in the Department of Urology of the Central Military Hospital and other centers nationally in which these procedures were performed by the same surgeon (RSP). A total of 36 procedures (27, artificial urinary sphincters, 5 AdVance and 4 Argus slings) were performed during this time period. ResultsA total of 36 procedures were performed, of which 27 were with artificial urinary sphincters (AUS) (75%), 5 AdVance (13.8%) and 4 Argus (11.1%) slings. The mean age was 70.3years (62-8), and the follow-up period was 24.8months (2-58). Overall success rate was 75% (27 of 36 patients). In the AUS group it was 81% (22-27 patients), and 100% with the AdVance transobturator sling (5 out of 5 patients), and in the group of patients managed with Argus it was 0% (0 of 4 patients). Post-operative complications were 18% (5 of 27 patients) in the AUS. These were due to urethrocutaneous fistula in 3 of 27 patients (11%), urethral erosion in 1 patient (3.5%), and infection with the filling mechanism extrusion through the scrotum in 1 patient (3.5%). ConclusionsMale urinary anti-incontinence devices are a useful management tool for the treatment of this pathology. The results of our study are adequate and comparable with those reported in the literature. The implantation of the AMS 800 artificial urinary sphincter is an effective, safe and reproducible procedure for the management of male urinary incontinence in our environment. The effectiveness of the slings in the group of patients in our series was variable. While the success rate was higher in patients managed with AdVance sling type, patients with sling Argus type had low success rates due to high rates of complications.© 2010 Sociedad Colombiana de Urología. Published by Elsevier España, S.L. All rights reserved.