InVance Bulbourethral Sling for the Treatment of Urinary Incontinence after Prostatectomy:Reports of 5 cases / 中国微创外科杂志

ABSTRACT

Objective To evaluate the efficacy and safety of the InVance bulbourethral sling for stress urinary incontinence in male patients.Methods Five male patients with incontinence after prostatectomy were treated with the perineal sling(InVance).The patients aged from 62 to 76 years(mean,67 years),and the history of the incontinence ranged from 2 to 6 years(average 4 years).Four of the cases were due to TURP,and one radical prostatectomy.All the cases had been failed to respond to conservative therapies.Before the procedures,urodynamic examination showed a mean abdominal leak point pressures(ALPP)at 25.5 cm H2O(20-32.5 cm H2O).Under spinal anesthesia,a 3-to 5-cm vertical incision was made between the scrotum and the anus with the patients at the lithotomy position to expose the right and left ischiopubic branches.We put the three screws with its sutures on each bone and fixed the sling.A cough test was performed systematically and ALPP was set over 60 cm H2O.Results The operation time was 50-85 min(mean,60 min)and intraoperative blood loss was 20-50 ml(average 30 ml).The catheter was removed at day 5 and none of the patients had urination difficulty.The cases were followed up for 6 to 24 months(mean,12.6 months),during which urodynamic examination showed an ALPP at 65 cm H2O(55-70 cm H2O).Among the patients,the 4 who had received TURP were cured,and the other one undergone radical prostatectomy was improved.Conclusions InVance bulbourethral sling is suitable for mild-to-middle urinary incontinence after prostatectomy.