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Management of recurrent post-prostatectomy incontinence after previous failed retrourethral male slings.
MedLine Citation:
PMID:  21470536     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our objective was to establish the feasibility of combining 2 minimally invasive procedures in patients with failed primary treatment (male sling) in post-prostatectomy incontinence (PPI) patients.
METHODS: From January 2007 to July 2008, 40 men with PPI were implanted with a suburethral tape (2 patients with Seratim, 3 with I-Stop and 35 with Advance). The median preoperative pad count was 4 (range 2-10). Prior to sling placement, 6 patients had undergone ProACT implantation. Of these, 4 patients required explantation due to balloon migration and 2 patients had their balloons kept in situ, with the balloons deflated.
RESULTS: Twenty-five patients were socially continent at this time. Fifteen patients (37.5%) did not improve or their improvement was not significant. These patients had a preoperative pad count between 7 and 10. Two of these patients had prostate adjustable continence therapy (ProACT) systems still in place. By gradually filling the balloons to 3 mL, both of these patients achieved complete continence, which was maintained at a mean follow-up of 8.5 months. Three patients with prior pelvic irradiation received an artificial urinary sphincter and achieved continence at mean follow-up of 8.3 months. The remaining 10 patients received a ProACT system in addition to the already implanted sling. After appropriate healing and filling of the balloons (average balloon volume 5 mL), all 10 patients reached complete continence; they were pad-free at a mean follow-up of 6 months (range 3-9).
CONCLUSIONS: The combination of ProACT and a suburethral tape was demonstrated to be a possible treatment option in recurrent or persistent PPI.
Authors:
Amr Al-Najar; Sascha Kaufmann; Soenke Boy; Carsten Maik Naumann; Peter-Klaus Jünemann; Christof Van Der Horst
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian Urological Association journal = Journal de l'Association des urologues du Canada     Volume:  5     ISSN:  1911-6470     ISO Abbreviation:  Can Urol Assoc J     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-07     Completed Date:  2011-07-14     Revised Date:  2011-08-01    
Medline Journal Info:
Nlm Unique ID:  101312644     Medline TA:  Can Urol Assoc J     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  107-11     Citation Subset:  -    
Affiliation:
Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
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