What if artificial urinary sphincter is not possible? Feasibility and effectiveness of ProACT for patients with persistent stress urinary incontinence after radical prostatectomy treated by sling

2020 ◽  
Vol 39 (5) ◽  
pp. 1417-1422
Author(s):  
Pierre Munier ◽  
Marc Nicolas ◽  
Thibault Tricard ◽  
Stéphane Droupy ◽  
Pierre Costa ◽  
...  
2020 ◽  
Vol 13 (5) ◽  
pp. 22-29
Author(s):  
S.V. Kotov ◽  
◽  
I.S. Pavlov ◽  
◽  

Introduction. The main cause of stress urinary incontinence in men is prostate surgery - radical prostatectomy, transurethral resection of the prostate (TURP), enucleation, etc. The gold standard for the surgical treatment of urinary incontinence after prostate surgery is the implantation of an artificial urinary sphincter. For the treatment of mild/moderate urinary incontinence, implantation of synthetic urethral male slings is recommended. For the treatment of severe urinary incontinence, implantation of artificial urinary sphincter recommended. According to the Decree of the Moscow Government dated 12.24.2019 N 1822-PP, surgical interventions on the organs of the genitourinary system with the implantation of synthetic complex and mesh prostheses are included in the standards for the provision of high-tech medical care. Materials and methods. The paper presents a surgical technique for implantation of an artificial urinary sphincter model AMS 800 (Boston Scientific, Boston, MA, USA) and a male urethral sling AdVance XP (Boston Scientific, Boston, MA, USA). The indications for surgical treatment of stress urinary incontinence in men are listed, the criteria for selecting patients for the implantation of an artificial bladder sphincter and the installation of a urethral sling are described, and described in detail. Conclusion. The materials presented in the lecture will help urologists in mastering the technique of implantation of an artificial bladder sphincter and urethral sling in men.


2017 ◽  
Vol 84 (4) ◽  
pp. 263-266 ◽  
Author(s):  
Christophe Llorens ◽  
Tobias Pottek

Study Design This is a retrospective, non-randomised study. Objectives The aim of this study was to evaluate safety and efficacy of artificial urinary sphincter ZSI 375 inserted in male patients with stress urinary incontinence (SUI). Methods Between May 2009 and January 2017, 45 men with SUI underwent ZSI 375 device insertion. Operations were performed in two French centres by one surgeon. Complications and pad used to manage continence were recorded. Results From May 2009 to January 2012, 45 patients with a mean age of 70.42 years underwent placement of the ZSI 375 device in France. The most common cause for incontinence was radical prostatectomy (RP, 33/45 ­patients, 73.33%). The minimal period of incontinence was 6 months. Twenty-seven out of 45 patients (60.00%) had a severe incontinence (at least four pads per day), 13 patients (28.89%) had moderate incontinence (three pads per day) and five patients (11.11%) had two pads per day. With a long follow-up, the ZSI 375 device was considered to be successful in 73.33% patients after 5 years (60 months) and 72% of patients after 7 years (84 months). The infection rate was 2.2 % affecting one in 45 patients. Six out of 45 patients presented a urethral erosion (13.33%). Mechanical failure with a revision occurred in three patients (6.67%). Conclusions The ZSI 375 device is a safe and effective device to treat severe SUI in men.


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