Le traitement de l’incontinence urinaire postopératoire de l’homme par la bandelette sous-urétrale à ancrage osseux View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2008-03

AUTHORS

C. Saussine, P. Mouracade

ABSTRACT

ObjectiveTo assess the outcomes of treating postoperative male stress urinary incontinence with the placement of bone-anchored American Medical System (AMS) InVance® suburethral slings (SUS).Materials and methodsBetween February 2005 and May 2007, 29 patients presenting with stress urinary incontinence secondary to prostate surgery were treated with the placement of bone-anchored InVance® suburethral slings. This SUS consisted of a polyester, siliconecoated sling positioned at the bulbar urethra and attached to the ischiopubic rami using six titanium screws. The patients presented according to the number of pads used per 24-hour period: mild (1 or 2 pads), moderate (3 to 4 pads) or severe (5 or more pads, or condom catheter). The number of pads, continence rate, and early and late complications are reported. Success (continence) was defined as the absence of both urge incontinence and the use of pads.ResultsThe average age of the patients was 67.5. Incontinence was mild in 12 patients (41.4%), moderate in six patients (20.7%) and severe in 11 patients (37.9%). The average time between prostate surgery and placement of the sling was 47.9 months, and the average duration of the treatment was 65.8 minutes. There were no perioperative complications. We observed two cases (7%) of acute urine retention that spontaneously resolved. Explantation of the SUS due to chronic perineal pain was performed in five patients (17%) after an average of 4.1 months (1 to 8.5 months). The rate of re-exami-nation for repositioning of the screws was 10.3% (3 patients). At three months, the continence rate was 58.6%; after an average follow-up of 10.4 months, the continence rate was 38% (11 patients). Residual incontinence was mild in 13 patients (44.8%), moderate in two patients (6.9%) and severe in three patients (10.3%). Four patients (13%) with refractory urinary incontinence after placement of the SUS underwent implantation of an artificial urinary sphincter.ConclusionThe screwed, bone-anchored suburethral sling is a viable treatment for postoperative male urinary incontinence. Morbidity is negligible (five explantations out of 29 patients). Outcomes are better in cases of mild to moderate incontinence. More... »

PAGES

15-18

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11608-008-0170-4

DOI

http://dx.doi.org/10.1007/s11608-008-0170-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1035473897


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