Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence
Autor(a) principal: | |
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Data de Publicação: | 2004 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | International Braz J Urol (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382004000400007 |
Resumo: | 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%) patients had minimal or no improvement. There was no case of urethral erosion. CONCLUSION: 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. |
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Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinenceurinary incontinencemenurinary sphincterprostheses and implantssurgical techniqueOBJECTIVE: 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%) patients had minimal or no improvement. There was no case of urethral erosion. CONCLUSION: 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.Sociedade Brasileira de Urologia2004-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382004000400007International braz j urol v.30 n.4 2004reponame:International Braz J Urol (Online)instname:Sociedade Brasileira de Urologia (SBU)instacron:SBU10.1590/S1677-55382004000400007info:eu-repo/semantics/openAccessSchaal,Carlos H.Costa,Renato P.Sala,Fernando C.Vanni,André P.Cortez,José P.eng2004-09-24T00:00:00Zoai:scielo:S1677-55382004000400007Revistahttp://www.brazjurol.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||brazjurol@brazjurol.com.br1677-61191677-5538opendoar:2004-09-24T00:00International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)false |
dc.title.none.fl_str_mv |
Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence |
title |
Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence |
spellingShingle |
Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence Schaal,Carlos H. urinary incontinence men urinary sphincter prostheses and implants surgical technique |
title_short |
Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence |
title_full |
Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence |
title_fullStr |
Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence |
title_full_unstemmed |
Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence |
title_sort |
Longitudinal urethral sling with prepubic and retropubic fixation for male urinary incontinence |
author |
Schaal,Carlos H. |
author_facet |
Schaal,Carlos H. Costa,Renato P. Sala,Fernando C. Vanni,André P. Cortez,José P. |
author_role |
author |
author2 |
Costa,Renato P. Sala,Fernando C. Vanni,André P. Cortez,José P. |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Schaal,Carlos H. Costa,Renato P. Sala,Fernando C. Vanni,André P. Cortez,José P. |
dc.subject.por.fl_str_mv |
urinary incontinence men urinary sphincter prostheses and implants surgical technique |
topic |
urinary incontinence men urinary sphincter prostheses and implants surgical technique |
description |
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%) patients had minimal or no improvement. There was no case of urethral erosion. CONCLUSION: 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. |
publishDate |
2004 |
dc.date.none.fl_str_mv |
2004-08-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382004000400007 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382004000400007 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1677-55382004000400007 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
dc.source.none.fl_str_mv |
International braz j urol v.30 n.4 2004 reponame:International Braz J Urol (Online) instname:Sociedade Brasileira de Urologia (SBU) instacron:SBU |
instname_str |
Sociedade Brasileira de Urologia (SBU) |
instacron_str |
SBU |
institution |
SBU |
reponame_str |
International Braz J Urol (Online) |
collection |
International Braz J Urol (Online) |
repository.name.fl_str_mv |
International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU) |
repository.mail.fl_str_mv |
||brazjurol@brazjurol.com.br |
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1750318069011447808 |