V06-10 FLUOROSCOPY FOR TEACHING PLACEMENT AND MECHANISM OF THE MALE URETHRAL SLING

Abstract

You have accessJournal of UrologyLower-Tract Reconstruction I: Sling/ Sphincter/ Penile & Urethral Reconstruction (V06)1 Apr 2020V06-10 FLUOROSCOPY FOR TEACHING PLACEMENT AND MECHANISM OF THE MALE URETHRAL SLING Ethan Matz*, Kyle Scarberry, and Ryan Terlecki Ethan Matz*Ethan Matz* More articles by this author , Kyle ScarberryKyle Scarberry More articles by this author , and Ryan TerleckiRyan Terlecki More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000885.010AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The transobturator male sling is an established option for mild to moderate stress urinary incontinence, which is most commonly seen after radical prostatectomy. Teaching sling surgery to residents and fellows can be challenging since the small incision can limit visualization. Also, the proposed mechanism of action for the male urethral sling has been largely based on theory rather than adequate dynamic visualization. We present a video to highlight our use of fluoroscopy to better educate learners on this operation. METHODS: This video highlights the three-dimensional pelvic anatomy relevant to placement of a male sling. The surgery is done through a standard perineal approach, but with use of fluoroscopy at key steps. These include needle passage to locate the trocar target within the obturator foramen, live visualization of trocar rotation, and the conformational change of the urethra during sling tensioning. RESULTS: The operation is successfully demonstrated with high-quality fluoroscopic images for better understanding of both the key surgical steps and mechanism of action for the male urethral sling. CONCLUSIONS: Placement of the male urethral sling is an important technique for surgeons to master in order to effectively manage men with stress urinary incontinence. The technique presented is novel based on the use of fluoroscopy to offer a more comprehensive educational experience for learners in the operating room. This approach may be suited for adoption at other academic training centers. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e559-e559 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ethan Matz* More articles by this author Kyle Scarberry More articles by this author Ryan Terlecki More articles by this author Expand All Advertisement PDF downloadLoading ...