[New male sling "Argus" for the treatment of stress urinary incontinence]. / Nuevo sling masculino "Argus" para el tratamiento de la incontinencia urinaria de esfuerzo.

OBJECTIVES: Male stress urinary incontinence is usually a consequence or sequel of a prostatic surgical procedure (radical prostatectomy, surgery for BPH or bladder neck sclerosis: adenomectomy, conventional and/or bipolar transurethral resection, laser...). This kind of surgery may have undesirable effects on the quality of life and patients' expectations, although we should bear in mind that the primary objective in patients with prostate adenocarcinoma is to cure cancer and for patients with obstructive lower urinary tract symptoms to improve their voiding quality Over the last decade, surgical procedures to compress the bulbar urethra with slings have been employed successfully in the treatment of male stress urinary incontinence, being considered highly effective in the treatment of post-prostatectomy incontinence in the long-term by groups with large experience. To describe the elements of the Argus system, its indications, and the surgical technique for its implant and adjustment, modified from Schäeffer and carried out by Victor Romano. METHODS: Argus system: The sling has three components: radiopaque cushioned system with silicone foam, 42 mm x 26 mm x 9 mm, which is waterproof to body fluids; two silicone columns formed by multiple conical elements, which allow system readjustment; and two radiopaque silicone washers (15 mm diameter and 2.9 mm width) which enable proper fixation and readjustment (Figure 1). Once the system is open, it is recommended to place the sling within antibiotic solution until implantation. CONCLUSIONS: 1. It is a safe, easy to implant, reproducible system, with few complications and a good cost-benefit relation. 2. Results are comparable to the gold standard, but it has the following advantages: immediate voiding control recovery and no need for patient training. 3. This article does not intend to show our short experience with only five cases, but we want to mention that all of them are continent with a good quality of life. 4. Our objective will be to publish our results when we can show a minimal follow-up.

Nuevo sling masculino "ARgus" para el tratamiento de la incontinencia urinaria de esfuerzo / New male sling "Argus" for the treatment of stress urinary incontinence

OBJETIVOS: La incontinencia urinaria masculina de esfuerzo, habitualmente se produce como consecuencia o secuela de una intervención quirúrgica prostática (prostatectomia radical abierta o laparoscópica, cirugía de la hiperplasia prostática benigna y esclerosis del cuello vesical: adenomectomia, resección transuretral convencional y/o bipolar, laser, etc) (1). Este tipo de cirugías puede tener efectos no deseados en la calidad de vida y las espectativas de los pacientes, aunque debemos ser conscientes que en los pacientes con adenocarcinoma de próstata el objetivo prioritario será curar el cáncer y en pacientes con síntomas obstructivos mejorar su calidad miccional. En la última década las intervenciones de compresión del bulbo uretral con cabestrillos han sido utilizadas con éxito en el tratamiento de la incontinencia urinaria de esfuerzo masculina (2), considerándose por grupos de gran experiencia en cabestrillos de gran efectividad en el tratamiento de la incontinencia urinaria post-prostatectomía a largo plazo (3). Describir los elementos que componen el sistema Argus, sus indicaciones y la técnica quirúrgica mediante la que se implanta y ajusta adecuadamente, modificada de Schäeffer (2) y llevada a cabo por Victor Romano (1). MÉTODO: Sistema Argus. El Sling está formado por tres componentes: sistema almohadillado radioopaco de espuma de silicona, impermeable a los fluidos corporales de 42 mm x 26 mm x 9 mm, dos columnas de silicona formadas por multiples formaciones conicas, que permiten el reajuste del sistema y dos arandelas de silicona radioopacas (15 mm de diámetro y 2’9 mm de espesor) que pemiten una correcta fijación y reajuste (Figura 1). Una vez abierto el sistema, se recomienda sumergir el Sling en una solución antibiótica hasta su utilización. CONCLUSIONES: 1. Se trata de un sistema seguro, fácil de implantar, reproducible, con pocas complicaciones y una buena relación coste beneficio. 2. Sus resultados son comparables al estandar de oro, pero con las siguientes ventajas: inmediata recuperación del control miccional y no requiere entrenamiento por parte del paciente. 3. Este trabajo no pretende aportar nuestra corta experiencia, que simplemente incluye 5 pacientes, aunque si queremos mencionar que se encuentran en la actualidad continentes y con una buena calidad de vida. 4. Nuestro objetivo será publicar nuestros resultados, cuando podamos aportar un seguimiento mínimo

OBJECTIVES: Male stress urinary incontinence is usually a consequence or sequel of a prostatic surgical procedure (radical prostatectomy, surgery for BPH or bladder neck sclerosis: adenomectomy, conventional and/or bipolar transurethral resection, laser...). This kind of surgery may have undesirable effects on the quality of life and patients` expectations, although we should bear in mind that the primary objective in patients with prostate adenocarcinoma is to cure cancer and for patients with obstructive lower urinary tract symptoms to improve their voiding quality. Over the last decade, surgical procedures to compress the bulbar urethra with slings have been employed successfully in the treatment of male stress urinary incontinence, being considered highly effective in the treatment of post-prostatectomy incontinence in the long-term by groups with large experience. To describe the elements of the Argus system, its indications, and the surgical technique for its implant and adjustment, modified from Schäeffer and carried out by Victor Romano. METHODS: Argus system: The sling has three components: radiopaque cushioned system with silicone foam, 42 mm x 26 mm x 9 mm, which is waterproof to body fluids; two silicone columns formed by multiple conical elements, which allow system readjustment; and two radiopaque silicone washers (15 mm diameter and 2.9 mm width) which enable proper fixation and readjustment (Figure 1). Once the system is open, it is recommended to place the sling within antibiotic solution until implantation. CONCLUSIONS: 1. It is a safe, easy to implant, reproducible system, with few complications and a good cost-benefit relation. 2. Results are comparable to the gold standard, but it has the following advantages: immediate voiding control recovery and no need for patient training. 3. This article does not intend to show our short experience with only five cases, but we want to mention that all of them are continent with a good quality of life. 4. Our objective will be to publish our results when we can show a minimal follow-up