Free Fascial Sling to Correct Urinary Incontinence After Prostatic Surgery: Results of Eight Operated Patients

Abstract

Eight men with total urinary incontinence after prostatic surgery were operated using a free fascial sling. Four patients were continent 7-36 months postoperatively. Two patients had stress incontinence and two patients had recidivating incontinence. The latter two patients were the only ones in whom the preoperative cystometry was abnormal.

Efficacy of the bulbourethral autologous sling in treating male stress urinary incontinence: a three-year experience from a single center

“…The use of free rectus fascia is cheap, easy to obtain and almost complication-free regarding erosion, infections, and perineal pain (10,13,19,21). Larger series and further follow-up is needed to assess long-term results.…”

“…There is no standardized definition of success for SUI procedures: definitions have included complete cure, social continence while wearing one small or thin pad or less daily (11), and improved quality of life (12). Success rates for different techniques of bulbourethral male sling have ranged from 25 to 93% (13)(14)(15)(16)(17)(18)(19)(20)(21)(22), though some investigators have suggested that patients with higher degree of pre-operative insentience (16) and those receiving radiation therapy (18,20) are at greater risk of failure.…”

Die Harninkontinenz des Mannes. Faszienzügelplastik zur Therapie der Streßinkontinenz

“…Die Variation der operativen Technik der Schiingenplastiken beim Mann betreffen die Schlingen-materialien (autolog, alloplastisch), den Entnahmeort von Faszienstreifen (Rektusscheide, Externusfaszie, Fascia lata), den operativen Zugangsweg (abdominal, perineal, abdomino-perineal), den Verlauf der Faszienschlinge (retropubisch, antepubisch) sowie die Plazierung der Schlinge in Beziehung zur Harnröhre (Blasenhals, Prostata, Apex prostatae, membranöse Harnröhre, bulbäre Harnröhre) (Tab. 5) (9,10,15,21,24,25,43,45,51,52,53,55,69,70,72,73). Obwohl zumeist gute bis sehr gute Erfolgsraten berichtet werden (Tab.…”

Treatment of postprostatectomy incontinence: Is the bulbourethral sling a viable alternative to the artificial urinary sphincter?

“…The concept of a male bulbourethral sling for postprostatectomy incontinence is not a recent concept proposed by the world's urologic community [9][10][11]. Descriptions of a postprostatectomy incontinence bulbourethral sling have included the use of retropubic needle passage (modified Stamey type procedure) with artificial graft material supporting the urethra [12][13][14]15••], the use of autologous fascia with passage around the urethra in a wrap-around technique from the abdomen to the perineum (a-p wrap) [1,9,10], as well as suburethral sling suspension with bone anchors (BAS) [3,16].…”

“…Descriptions of a postprostatectomy incontinence bulbourethral sling have included the use of retropubic needle passage (modified Stamey type procedure) with artificial graft material supporting the urethra [12][13][14]15••], the use of autologous fascia with passage around the urethra in a wrap-around technique from the abdomen to the perineum (a-p wrap) [1,9,10], as well as suburethral sling suspension with bone anchors (BAS) [3,16]. It is felt that placement of a sling alleviates incontinence by compressing and elevating the urethra, thereby increasing urethral resistance to abdominal pressure [15••].…”