The Early Results of Male Bulbourethral Sling for Post Radical Prostatectomy Incontinence from June 2010 to August 2011
Keywords:
Radical Prostatectomy, Male incontinence, Bulbourethral slingAbstract
Male Urinary Incontinence following the Radical Prostatectomy can be a devastating complication significantly impacting quality of life. Male sling is one of the surgical treatment option, but data are still lacking.
Objectives: To assess the outcomes and adverse events of the bulbourethral sling for treating postprostatectomy urinary incontinence at Siriraj hospital.
Design, setting and Participants: We conducted a prospective evaluation on 22 patients treated at Siriraj hospital between June 2010 and August 2011 for male urinary incontinence following radical prostatectomy.
Intervention: Placement of bulbourethral sling
Measurements: Patients were evaluated by medical history, urinalysis, daily pad use at baseline and during follow up. Intraoperative and postoperative complications, self-evaluation questionnaire assessment were collected. Cure was defined as no pad usage postoperatively and improvement as a reduction in number of pad usage per day.
Results and Limitations: The mean operative time was 109.32+30.33 min (range 45-185 min). Mean estimated blood loss was 199.55+137.16 ml. (range 50-600 ml.). Two patients had the estimated blood loss >500 ml. (500 and 600 ml.) due to severe periurethral adhesion. Complications and their incidence included urinary retention 3 cases (13.6%), urethral injury 2 cases (9.1%) and wound infection for 1 case (4.5%). The two patients with intraoperative urethral injury were treated with primary repaired and suprapubic cystostomy, and then sling placement was continued. All patients with urinary retention and wound infection are managed conservatively. After a mean follow up time of 363 days (Median 377 days, range 139-503), 3 patients (13.6%) were cured, 11 patients (50%) were improved and 8 patients (36.3%) were failed.
Conclusions: The Outside-In transobturator sling technique is an effective procedure for treatment Postprostatectomy SUI especially in patient with mild to moderate degree. It seems to be safe, with few complications.
