Zbigniew Wolski, Magdalena Mikulska-Jovanović
- Katedra i Klinika Urologii Ogólnej, Onkologicznej i Dziecięcej CM w Bydgoszczy UMK w Toruniu
Introduction. Incontinence persists in from few to dozen percent of patients after severe damage of sphincter after prostate and urethra surgery. Placement of artificial urinary sphincter is the reference standard with an 70 to 90% overall success rate. However contraindications are patients with no good mental and health conditions and high cost of artificial sphincter. The improvement of surgical technique and excellent results of sling procedure in women made new male tapes coming back in men.
Objectives. The aim is to present the method of transobturator sling in men and early results.
Materials and methods. We treated two men with incontinence afrer radical prostatectomy (patient S.F. 68 y) and after adenomectomy and transurethral resection of prostate (A.W. 81 y). Indications for sling were mild incontinence in first younger patient and general condition in older one. Bulbourethral transobdurator sling with monifilament tape I-STOP TOMS was implanted into both patients.
Results. No intra- and postoperative complications were observed. Both patients had full continence without residual of urine immediately after catheters removal on 2 and 3 postoperative days.
Conclusions. Transobturator sling is valuable alternative to artificial sphincter, specially, in oldest men or/and with mild urinary incontinence. Longer follow up and more patients are necessary.