Male sling as a rehabilitation procedure after operations due to prostate surgery

Kachmazov A.A., Verzin A.V., Romih V.V., Perepechin D.V.

Male urinary incontinence is a serious complication of the pelvic surgery. A modern approach is a male sling placement for continence restoration. Our study included 39 patients, which were operated in years 2009-2011 in the Scientific Institute of Urology due to urinary incontinence. Mean age of the patients was 64 years (range 51-81). Stress urinary incontinence was a consequence of the following operations due to the prostate cancer and benign prostatic hyperplasia: radical prostatectomy – 11 patients, transurethral prostate resection – 14, open prostatectomy – 8, brachytherapy – 2, radiation therapy – 2, HIFU-therapy – 1 patient. Intermediate grade of the incontinence severity was present in 35 patients, in 4 patients the severe incontinence was a case. Intraoperative complications have not occurred. A median duration of the operation was 63 minutes (range 45-90). Full continence was achieved in 25 patients (64.1%). An improvement, which was present as a usage of the reduced amount of the pads resulted in 8 patients (20.5%). Six patients (15.4%) had no effect on the continence. An overall efficacy of the operation was 84.6%. Regulation of the tension was necessary due to the absence of the effect in 12 patients (30.8%), which in a matter of fact could not be considered a complication, rather a constructive peculiarity of the sling system. Sling system was removed in 4 patients (10.3%) due to the wound infection. Sling placement is an effective method of the male incontinence treatment, as one of the advantages of which an easy correction after operation under local anesthesia could be stated. The other merits are the absence of the necessity in the additional measures to carry out the micturition and the possibility to combine the sling placement with the implantation of the intraurethral stent, when the stricture is a case.

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