ABSTRACT
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.
Subject(s)
Prostatectomy/adverse effects , Urinary Incontinence/therapy , Urinary Sphincter, Artificial , Aged , Aged, 80 and over , Constriction , Device Removal , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications , Retrospective Studies , Treatment Outcome , Urinary Sphincter, Artificial/adverse effectsABSTRACT
PURPOSE: We report long-term followup of a new device for the treatment of urinary incontinence in children. MATERIALS AND METHODS: A periurethral constrictor was implanted in 29 boys and 13 girls 3 to 17 years old (mean age 10.2, median age 10) during the last 9 years. Of the patients 29 had neurogenic bladder, 12 had bladder exstrophy and 1 had megalourethra. Bladder augmentation was done simultaneously in 34 patients. The device was implanted around the bladder neck in 41 cases and at the bulbous urethra in 1. Continence was achieved in all cases when the device remained in situ. RESULTS: Followup ranged from 4 to 104 months (mean 63, median 75). In 23 patients (82.1%) in the neurogenic group and the patient with megalourethra the device remains in situ and continence is preserved. Clean intermittent catheterization is performed without difficulty. In 4 patients the device was extracted due to erosion or infection. The device was extracted due to erosion and urine extravasation in 10 exstrophy group patients. Two patients have the device and perform post-void catheterization. CONCLUSIONS: Based on the data from this long-term study we conclude that the periurethral constrictor is a safe alternative for the treatment of urinary incontinence in children. Like other devices it must be used with caution in cases of bladder exstrophy.
