ABSTRACT
Implantation of an artificial urinary sphincter (AUS) is an established surgical option for treating female stress urinary incontinence due to internal sphincter deficiency (ISD). However, this operation is often performed as an open surgical procedure. Here, we introduce an endoscopic extraperitoneal approach for implanting an artificial urinary sphincter. Two women (ages 22 and 79 years) underwent endoscopic extraperitoneal implantation of the AMS 800 artificial sphincter. In both cases, neurogenic bladder disease was the underlying cause of ISD. The endoscopic extraperitoneal approach allowed excellent preparation and mobilisation of the bladder neck and implantation of the AUS. The overall operating time was <120 min. Both patients were mobilised on the same day and could be discharged from the hospital after 5-6 days. The AUS were activated after 6-9 weeks. However, after an average of 6 months, total continence was achieved in both patients. Laparoscopic extraperitoneal implantation of AUS in women with moderate to severe stress urinary incontinence is safe and might be less traumatic to neighbouring organs than the open operation. However, more implantations are needed to evaluate the long-term feasibility of this method.
Subject(s)
Endoscopy/methods , Female Urogenital Diseases/rehabilitation , Female Urogenital Diseases/surgery , Urinary Incontinence, Stress/rehabilitation , Urinary Incontinence, Stress/surgery , Urinary Sphincter, Artificial , Adult , Aged , Female , Female Urogenital Diseases/pathology , Humans , Prosthesis Implantation/methods , Treatment Outcome , Urinary Incontinence, Stress/pathologySubject(s)
Female Urogenital Diseases/therapy , Geriatrics , Male Urogenital Diseases/therapy , Urology , Aged , Aged, 80 and over , Female , Female Urogenital Diseases/diagnosis , Female Urogenital Diseases/epidemiology , Female Urogenital Diseases/rehabilitation , Geriatric Nursing , Humans , Male , Male Urogenital Diseases/diagnosis , Male Urogenital Diseases/epidemiology , Male Urogenital Diseases/rehabilitation , UrinationABSTRACT
Inpatient rehabilitation and "Anschlussheilbehandlung" (rehabilitation soon after operation or acute intervention) are effective and economic for long-term improvement of urologic patients. Only therapy guided by urologic specialists during rehabilitation and afterwards guarantees the possibility of excellent results. Especially QOL and functional deficits are improved markedly by urologic rehabilitation. Therefore, inpatient urologic rehabilitation should be initiated more often in the future.
Subject(s)
Female Urogenital Diseases/rehabilitation , Male Urogenital Diseases , Patient Admission/economics , Postoperative Complications/rehabilitation , Quality Assurance, Health Care/organization & administration , Rehabilitation Centers/organization & administration , Urogenital Neoplasms/rehabilitation , Combined Modality Therapy , Cost-Benefit Analysis , Female , Female Urogenital Diseases/psychology , Follow-Up Studies , Humans , Male , Outcome and Process Assessment, Health Care/economics , Patient Care Team/economics , Patient Care Team/organization & administration , Physical Therapy Modalities/economics , Physical Therapy Modalities/organization & administration , Postoperative Complications/psychology , Quality Assurance, Health Care/economics , Quality of Life/psychology , Urogenital Neoplasms/psychologyABSTRACT
In the 50 years since pelvic muscle exercises were introduced for the nonsurgical management of pelvic floor dysfunction related to parturition, a variety of approaches have been introduced and the scope of indications has grown. This article describes the evaluation of patients with pelvic floor complaints, discusses additional techniques for performing pelvic muscle exercises including biofeedback and electrical stimulation, details a comprehensive educational program, and examines the literature on the use of pelvic muscle exercises for the treatment of stress and urge urinary incontinence.
Subject(s)
Female Urogenital Diseases/rehabilitation , Pelvic Floor , Urinary Incontinence/rehabilitation , Biofeedback, Psychology , Electric Stimulation Therapy , Exercise Therapy , Female , Female Urogenital Diseases/diagnosis , Humans , Pessaries , Urinary Incontinence/diagnosisSubject(s)
Female Urogenital Diseases/diagnosis , Health Resorts , Male Urogenital Diseases , Polymerase Chain Reaction , Urinary Tract Infections/diagnosis , Female , Female Urogenital Diseases/economics , Female Urogenital Diseases/rehabilitation , Health Resorts/economics , Humans , Male , Polymerase Chain Reaction/economics , Russia , Urinary Tract Infections/economics , Urinary Tract Infections/rehabilitationABSTRACT
During the past three decades, the use of implants both in urology and other surgical specialties has experienced exponential growth. The development of implantable genitourinary prostheses has similarly grown from simple testicular substitutes to the large group of implantable penile prostheses, artificial urinary sphincters, prostheses in neurology, and possible future developments of artificial bladder and ureteral materials. The majority of urologic prostheses are constructed of silicone, because it is relatively inert, but nevertheless silicone causes some local tissue reactions and deteriorates with time. Currently, much research is underway studying the effects on the human host. Although multiple mechanical malfunctions of these prosthetic devices have occurred, periprosthetic infection is the most disastrous complication which usually leads to removal of the prostheses. This article gives the clinician an overview of common complex urologic implants, especially the current development of prostheses in the field of neurology.
