Periurethral constrictor: late results of the treatment of post prostatectomy urinary incontinence.

OBJECTIVES: We evaluated retrospectively, the long-term outcome of patients with post-prostatectomy urinary incontinence (PPUI) after placement of the Periurethral Constrictor (PUC). MATERIALS AND METHODS: Fifty-six men with severe PPUI were studied, with a mean age of 68.5 years old. Fifty-one men had PPUI due to radical surgery having the device placed around the bulbous urethra, and five individuals with benign prostatic hypertrophy (BPH) had placement around the bladder neck. The mean follow-up was 82.2 months. RESULTS: Twenty-two patients (39.28%) became continent (0 to 1 pad a day) and 34 (60.72%) were incontinent. Complications were as follows: urethral erosion in 15 (26.78%); mechanical malfunction in 2 (3.5%); infection in 2 (3.5%); urinary fistula in 1 (1.7%); Urinary tract infection1 (1.7%). Twenty-three patients needed to have the device removed (41.07%). Success rate (continent me) was 30.35%. CONCLUSION: In the present series the PUC was not effective for the treatment of severe PPUI in the long-term follow-up.

Periurethral constrictor: late results of the treatment of post prostatectomy urinary incontinence

OBJECTIVES: We evaluated retrospectively, the long-term outcome of patients with post-prostatectomy urinary incontinence (PPUI) after placement of the Periurethral Constrictor (PUC). MATERIALS AND METHODS: Fifty-six men with severe PPUI were studied, with a mean age of 68.5 years old. Fifty-one men had PPUI due to radical surgery having the device placed around the bulbous urethra, and five individuals with benign prostatic hypertrophy (BPH) had placement around the bladder neck. The mean follow-up was 82.2 months. RESULTS: Twenty-two patients (39.28 percent) became continent (0 to 1 pad a day) and 34 (60.72 percent) were incontinent. Complications were as follows: urethral erosion in 15 (26.78 percent); mechanical malfunction in 2 (3.5 percent); infection in 2 (3.5 percent); urinary fistula in 1 (1.7 percent); Urinary tract infection1 (1.7 percent). Twenty-three patients needed to have the device removed (41.07 percent). Success rate (continent me) was 30.35 percent. CONCLUSION: In the present series the PUC was not effective for the treatment of severe PPUI in the long-term follow-up.

Nonsecretory intestinocystoplasty: a 15-year prospective study of 183 patients.

PURPOSE: Children and young adults treated with augmentation procedures with total intestinal flaps are at increased risk for specific complications in the long term. The aim of the present study was to demonstrate the long-term results of demucosalized bladder augmentation. MATERIALS AND METHODS: A total of 183 patients (92 males and 91 females) were treated with bladder augmentation with the use of de-epithelialized intestinal segments. Patient age ranged from 3 months to 53 years, with a mean of 13.51 years (median 11.0). Of the patients 121 (66.1%) presented with neurogenic bladder, 50 (27.3%) with bladder exstrophy, 7 (3.8%) with tuberculosis, 4 (2.2%) with posterior urethral valves and 1 (0.5%) with female hypospadias. A mold over which the de-epithelialized segment of bowel was applied was used in all patients. A total of 151 cases were augmented using sigmoid colon and 32 using ileum. Data from bladder capacity and compliance were used to evaluate the results. RESULTS: Mean followup was 75.6 months (range 2 to 189). A total of 23 cases (12.6%) were considered failures. Mean bladder capacity was 250.0 ml. An increase of 342.4% was observed postoperatively. Median preoperative compliance was 1.6 ml/cm/H2O. An increase of 762.5% was observed during followup. Seven patients presented with bladder stones. Spontaneous bladder perforation was seen in 2 cases. CONCLUSIONS: Significant increase in bladder capacity and compliance was achieved and maintained in the long term. The number of complications was lower compared to traditional methods of augmentation.