ABSTRACT
Objective To evaluate the long-term efficacy of endoscopic injection of Macroplastique (Polydimethylsiloxane; PDMS) in male and female urinary incontinence (UI). Patients and Methods A total of 87 patients with different causes of urinary incontinence have been treated by endoscopic injection of PDMS at our department between 1997 and 2001. The group consisted of 39 male and 48 female patients with a mean age of 58 and 44 years; respectively. All patients underwent a sophisticated history taking including urodynamics and were instructed to complete a pre- and postoperative voiding diary. The results were evaluated by questionnaire at 1; 6; 12 and 24 months after injection. The outcome was classified as dry in all circumstances; improved or failed. Results At one month; 5 male (13) and 10 female (21) patients were dry; while 27 males and 29 females had improved and treatment had failed in 7 males (18) and 9 females (19). At the last follow-up (mean injections = 2.5); 12 males patients (31) and 27 female patients (56) were classified as dry; 18 males (46) and 14 females (29) were improved; while in 9 males (23) and 7 females (15) the procedure had failed. The overall success rate (dry and improved) was 77for the males and 85for the females. Conclusion The use of PDMS (Macroplastique) is a good and effective alternative for the treatment of intrinsic sphincter deficiency in male and female patients. The implants do not lose volume over time and have a good long-term effect
Subject(s)
Female , Injections , Male , Urinary Incontinence/therapyABSTRACT
Objective: To precise the clinical features and evaluate the accuracy of treatment by JJ endo-prsthesis associated with antituberculous medications and more or less corticoid treatment. Patients and Methods: From January 1992 to December 2001; 12 patients presenting with ureteral strictures due to tuberculosis were treated by JJ catheter for a mean of 12 months in association with antituberculous medication for 8 months and corticoid treatment in 2 cases. The population included 6 males and 6 females aged 20 - 73 years (mean age: 40 years). Results: The most frequent clinical expressions were pain (66.66) and haematuria (41.6). The stricture was unilateral and unifocal in 4 casers; unilateral and bifocal in 3 cases; multifocal in 3 cases. The controlateral kidney was normal in 9 cases and mastic in 3 cases. The stricture was bilateral in 2 cases; located on the right ureter in 6 cases and on the left side in 4 cases. The outcome was favourable in 9 cases with complete disappearance of the stricture in 4 cases; a partial regression of the stricture and the pyelo-calyceal dilatation in 5 cases; while the condition of the remaining 3 cases deteriorated 6 months after removal of the JJ catheter leading to reconstructive surgery using a Boari flap (1 case); a psoas hitch (1 case) and uretero-pelvic junction plastic surgery (1 case). Conclusion: JJ endoprosthesis associated with antituberculous medication is proposed as an alternative treatment to classic surgery. A corticoid treatment used early can be helpful to reduce the stricture