Abstract:
The treatment of male severe stress incontinence (MUI) after surgery is the implantation of an artificial urinary sphincter (AUS). Traditionally you need two incisions: perineal and inguinal. Our objetive is present a series of patients treated with the Zephyr 375 EUA implant through a single perineal incision. We present six men operated on for MUI after Transuretral resection of the prostate (TURP) (1) and radical prostatectomy (5). Preoperatively we perform Pad-Test and cystoscopy. Under epidural anesthesia, a vertical perineal incision was made and dissection up to the bulbospongiosus muscle was divided and we dissected the bulbar urethra. After removing the probe, we place the cuff, checking that it reaches the appropriate pressure, leaving it deactivated. To place the pump-reservoir, we digitally develop a scrotal dartos pocket from the perineum that we close with Vicryl 3/0. After closing the muscle with 3/0 Vicryl, we left a suction drain and a bladder catheter. The mean age was 63 years (55-72). Mean surgical time was 68 minutes (60-85). All were discharged the next day without catheter and drain. All patients comfortably palpated the scrotal reservoir-pump. After activation, all patients were continent without needing additional adjustment, using 3 a safety pad. The degree of satisfaction was very high, all of them affirmed that they would undergo the same intervention again. The Zephyr 375 urinary sphincter allows placement through a single perineal incision, reducing surgical time, simplifying the technique, and reducing morbidity without compromising the functional outcome.
摘要:
手术后男性重度压力性尿失禁(MUI)的治疗方法是植入人工尿道括约肌(AUS)。传统上,你需要两个切口:会阴和腹股沟。我们的目标是通过会阴单切口使用Zephyr375EUA植入物治疗的一系列患者。我们介绍了六名在经尿道前列腺切除术(TURP)(1)和根治性前列腺切除术(5)后接受MUI手术的男子。术前我们进行垫测试和膀胱镜检查。在硬膜外麻醉下,做了一个垂直的会阴切口,切开直到球海绵状肌,我们切开了球尿道。取出探头后,我们放置袖口,检查它是否达到适当的压力,让它停用。要放置泵储液罐,我们用Vicryl3/0封闭的会阴数字化开发了阴囊dartos口袋。用3/0Vicryl关闭肌肉后,我们留下了一个抽吸引流管和一个膀胱导管.平均年龄为63岁(55-72)。平均手术时间为68分钟(60-85分钟)。第二天所有人都出院,没有导管和引流。所有患者都舒适地触诊了阴囊储液泵。激活后,所有患者都是大陆,不需要额外的调整,使用3个安全垫。满意度很高,他们都确认他们将再次接受同样的干预。Zephyr375尿道括约肌允许通过单个会阴切口放置,减少手术时间,简化技术,在不损害功能结果的情况下降低发病率。