Treatment Of Post-prostatectomy Urinary Incontinence Research Articles

Re: Surgical technique using AdVance ™ sling placement in the treatment of post-prostatectomy urinary incontinence

Re: Surgical technique using AdVance ™ sling placement in the treatment of post-prostatectomy urinary incontinence

Re: Surgical technique using AdVance ™ sling placement in the treatment of post-prostatectomy urinary incontinence

Re: Surgical technique using AdVance ™ sling placement in the treatment of post-prostatectomy urinary incontinence

Surgical technique using AdVance™ Sling placement in the treatment of post-prostatectomy urinary incontinence

To describe and illustrate a new minimally invasive approach to the treatment of male stress urinary incontinence following prostatectomy. Our initial experience consisted of four patients treated with the Advance sling for post-prostatectomy urinary incontinence. Sling placement involves the following steps: 1. Urethral dissection and mobilization, 2. Identification of surgical landmarks, 3. Placement of needle passers through the obturator foramen, 4. Mesh advancement, 5. Mesh tensioning and fixation, 6. Incision closure. Based on our initial experience, we believe that the Advance Male Sling System may be a safe technique for the treatment of male stress urinary incontinence. This technique is easy to perform and may offer a reproducible, transobturator approach. Further patient accrual is ongoing to assess the safety and reproducibility of this technique. Also, additional study will focus on efficacy standards and complication rates.

V871: Advance Sling Placement in the Treatment of Post-Prostatectomy Urinary Incontinence

V871: Advance Sling Placement in the Treatment of Post-Prostatectomy Urinary Incontinence

Prolene (mesh) bulbourethral sling in male incontinence

Objective:We present our preliminary results of bulbar urethral sling (single bolster) in treatment of postprostatectomy urinary incontinence (PPUI).Materials and Methods:From May 2003 to June 2005, six patients with postprostatectomy urinary incontinence (transurethral resection of prostate in five patients and after open prostatectomy in one patient) underwent prolene mesh bulbar urethral sling surgery. Preoperative evaluation included physical examination, neurological assessment, stress cystogram and urethrocystoscopy. Urodynamic evaluation was done in all patients for abdominal leak point pressure and ruling out bladder pathology.Results:Urodynamic studies did not demonstrate bladder instability in any patient. Mean abdominal leak point pressure was 43cm of water (range 26–80 cm of water). Mean duration of hospital stay was 3.2 days. Follow-up ranged from 6–22 months. Four patients out of six patients were completely dry till their last follow-up. One patient developed mild stress incontinence after one year of the surgery and required use of one to two pads per day. Mean pad use after surgery was 0.6 pads per day in comparison to mean pad usage of 6.4 pads per day preoperatively. One patient was over-continent after the procedure and required clean intermittent catheterization till last follow-up (six months). Mean cost of the procedure was $ 350+15.Conclusion:Prolene bulbar urethral sling (single bolster) is an economically effective option in patients with postprostatectomy urinary incontinence.

Treatment of postprostatectomy urinary incontinence: the case against the male sling

For the man suffering from urinary incontinence following prostatectomy, two surgical options are currently available: the bulbous urethral sling and the artificial urinary sphincter (AUS). The authors discuss the literature for the two techniques, and explain why they believe AUS implantation is the preferred option in this patient population.

336: Principles of Anatomy for Male Transobturator Tape (TOT) Suspension for the Treatment of Post-Prostatectomy Urinary Incontinence

You have accessJournal of UrologyDiscussed Poster, Sunday, May 21, 2006, 1:00 - 4:00 pm1 Apr 2006336: Principles of Anatomy for Male Transobturator Tape (TOT) Suspension for the Treatment of Post-Prostatectomy Urinary Incontinence Christian Gozzi, Christian Schwentner, and Peter Rehder Christian GozziChristian Gozzi More articles by this author , Christian SchwentnerChristian Schwentner More articles by this author , and Peter RehderPeter Rehder More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)32592-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "336: Principles of Anatomy for Male Transobturator Tape (TOT) Suspension for the Treatment of Post-Prostatectomy Urinary Incontinence." The Journal of Urology, 175(4S), p. 110 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 175Issue 4SApril 2006Page: 110 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Christian Gozzi More articles by this author Christian Schwentner More articles by this author Peter Rehder More articles by this author Expand All Advertisement PDF DownloadLoading ...

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

Description and early results of a new urethral sling technique for treatment of postprostatectomy urinary incontinence, which combines efficacy, low cost and technical simplicity. 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. 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%) patients had minimal or no improvement. There was no case of urethral erosion. This new sling technique has shown highly encouraging preliminary results. Its major advantage over other surgical techniques for treatment of moderate or severe stress urinary incontinence is the simplicity for its execution and low cost. A long-term assessment, addressing maintenance of continence, detrusor function and preservation of the upper urinary tract, is still needed.

COLLAGEN INJECTION FOR TREATMENT OF URINARY INCONTINENCE IN CHILDREN

We assess the success rate of periurethral collagen injection in children with neurogenic bladder dysfunction secondary to myelomeningocele. From 1992 to 1998, 15 male and 5 female patients with spina bifida (age 13.3 +/- 3.8 years) underwent endoscopic collagen injection for the treatment of urinary incontinence secondary to sphincter deficiency. Mean followup was 4.2 years. Pretreatment urodynamic study showed a stable compliant bladder with an average leak point pressure of 52 cm. H2O (range 23 to 100). Concurrent medical management included anticholinergics in 15 cases, agonists in 3, and clean intermittent catheterization in 16. Five patients had undergone previous ileocystoplasty. Collagen injections were given with the patient under general anesthesia. The number of injections was 1 in 5 cases, 2 in 11, 3 in 3, and 4 in 1. Average collagen volume injected per treatment was 6.6 cc (range 2 to 13). All patients were evaluated on a subjective continence scale of no change (wet), improved or completely dry at the time of assessment. Of the 20 patients, 16 had no change, 3 showed improvement and 1 was dry. Initial improvement in the first 2 months after injection deteriorated thereafter in 16 cases. The previously reported high success rate of collagen injection is not supported by this study. With long-term followup collagen injection is rarely effective for treating urinary incontinence in children with neurogenic sphincter deficiency.

Transurethral Collagen Injection for Treatment of Postprostatectomy Urinary Incontinence in Men

No AccessJournal of UrologyUrological Survey: Abstracts: Voiding Function and Dysfunction, and Female Urology1 Mar 1998Transurethral Collagen Injection for Treatment of Postprostatectomy Urinary Incontinence in Men T.L. Griebling, K.J. Kreder, and R.D. Williams T.L. GrieblingT.L. Griebling More articles by this author , K.J. KrederK.J. Kreder More articles by this author , and R.D. WilliamsR.D. Williams More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)63863-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Transurethral Collagen Injection for Treatment of Postprostatectomy Urinary Incontinence in Men." The Journal of Urology, 159(3), p. 1110 Department of Urology, University of Iowa, Iowa City, Iowa.© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 159Issue 3March 1998Page: 1110 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information T.L. Griebling More articles by this author K.J. Kreder More articles by this author R.D. Williams More articles by this author Expand All Advertisement PDF downloadLoading ...

Transurethral Collagen Injection for Treatment of Postprostatectomy Urinary Incontinence in Men

Transurethral Collagen Injection for Treatment of Postprostatectomy Urinary Incontinence in Men

Treatment of postprostatectomy urinary incontinence with behavioral methods.

Prostate cancer is the most commonly diagnosed cancer in men. The radical prostatectomy is the treatment of choice for localized cancer; however, this surgery carries with it the potential complication of urinary incontinence postoperatively. The increasing number of radical prostatectomies each year will thus lead to a growing number of patients suffering from postprostatectomy urinary incontinence. According to the medical literature, the treatment of postprostatectomy incontinence is almost always limited to pharmacological or surgical therapy. Because of the failure of the standard treatment options, many men are left to live with their incontinence. The guidelines for the treatment of urinary incontinence recommend the use of behavioral methods as first-line treatment for stress and urge incontinence. The potential treatment of postprostatectomy incontinence with the use of behavioral methods has a promising future for the advanced practice nurse and for the men who are affected.

Transurethral collagen injection for treatment of postprostatectomy urinary incontinence in men

Objectives. Transurethral injection of glutaraldehyde cross-linked bovine collagen has recently been advocated as a potentially useful treatment modality for management of urinary incontinence. The reported clinical experience with urethral collagen injection in adult males has been limited. Methods. This study summarizes the current literature and reviews the clinical results of collagen injection in a group of 25 men with incontinence after either transurethral or radical prostatectomy. Results. The overall results in this series were disappointing. Only 2 patients (8%) achieved significant improvement with this treatment. Eight patients (32%) experienced minimal improvement in symptoms, and 15 (60%) remained incontinent with no improvement in symptoms after collagen injection. The number of injection procedures and volume of collagen material implanted did not correlate with clinical outcome. Five patients (20%) have subsequently required placement of an artificial urinary sphincter to control their incontinence. Conclusions. We conclude that transurethral injection of glutaraldehyde cross-linked bovine collagen has a limited role in the management of urinary incontinence in adult men after prostatectomy.

Rectus Fascial Sling Suspension of the Vesicourethral Anastomosis After Radical Prostatectomy

A study was performed to ascertain if fascial sling suspension of the anastomosis after radical retropubic prostatectomy would enhance postoperative continence rates. A fascial sling suspension with a strip harvested from the fascia of the rectus muscle was performed at the time of radical retropubic prostatectomy in 30 patients (group 2). Postoperative continence was compared to that of 30 previous patients (group 1) operated on by the same surgeon. Complete continence rates (no protection needed at any time) were 18 of 30 men (60%) in group 2 and 10 of 30 (33%) in group 1 (p = 0.069) at 1 month, 28 of 30 men (93%) in group 2 and 21 of 30 (70%) in group 1 (p = 0.042) at 3 months, 30 of 30 in group 2 (100%) and 27 of 30 (90%) in group 1 at 6 months, and 30 of 30 in group 2 (100%) and 28 of 30 (93%) in group 1 at 9 and 12 months. Fascial sling suspension resulted in an earlier return and more complete recovery of urinary continence in men undergoing radical prostatectomy.

Treatment of post-prostatectomy urinary incontinence using a silicone gel prosthesis.

Summary After trials with various urethral compression procedures to restore continence in male patients, an implantable sponge-like prosthesis has been devised which has produced encouraging results in 47 patients followed a minimum of 3 and a maximum of 15 months. A number of patients have obtained early cures and subsequently lost control. Some of these patients were subsequently improved by injecting the implanted pillow with hyperosmotic fluid percutaneously. Excellent results have been obtained in 80 per cent of patients who had not been subjected to previous anti-incontinence operations. 53 per cent of patients who had undergone earlier unsuccessful procedures to cure their incontinence were substantially improved or cured after the insertion of a silicone gel prosthesis. The operation is a simple one with few postoperative complications and we believe that because of these features it deserves further trial as the initial effort to control this disabling iatrogenic problem.