JOURNAL ARTICLE
Add like
Add dislike
Add to saved papers

Bulbourethral composite suspension:: a new operative technique for post-prostatectomy incontinence.

PURPOSE: A new bulbourethral sling procedure is proposed for patients with post-radical prostatectomy incontinence.

MATERIAL AND METHODS: Bulbourethral composite suspension was performed in 16 consecutive patients, of whom 6 (38%) had severe stress incontinence and depended on a condom urinal catheter. Urinary stress incontinence was assessed preoperatively by a modified pad test, urethrocystoscopy and urodynamic evaluation. The procedure was performed with a longitudinal perineal and a transverse suprapubic incision with the patient under regional anesthesia. We placed a porcine dermis for urethral protection and a polypropylene retropubic sling, which was tied suprapubically with the patient coughing and during retrograde urethral closure pressure monitoring at 60 cm H2O.

RESULTS: Preoperative evaluation excluded detrusor instability and urethral stricture. The polypropylene band was placed without neurogenic or vascular complications. All patients had primary wound healing. Patients reported only minimal postoperative pain. Clinical followup was performed a median of 14 months postoperatively (range 6 to 32). Of the 16 patients 11 (69%) were completely dry and 1 (6%) reported improved continence, while 4 (25%) had no benefit, including 2 who underwent an artificial sphincter procedure. Preoperative mean daily pad use decreased from 7 (range 2 to 12) to 1 (range 0 to 10) postoperatively (p = 0.0004) and postoperative quality of life improved significantly (p <0.0001).

CONCLUSIONS: Bulbourethral composite suspension is a new, efficient operative sling technique in patients with severe post-prostatectomy stress urinary continence. Because morbidity and complications are low, this new technique may become an alternative to artificial urinary sphincter implantation. Long-term observation of urethral and detrusor function is necessary to elucidate the specific contribution of bulbourethral composite suspension in restoring urinary continence after radical prostatectomy.

Full text links

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app