Safety and Efficacy of Periurethral Constrictor Implantation for the Treatment of Post–radical Prostatectomy Incontinence

Introini, Carlo; Naselli, Angelo; Zaninetta, Giovanni; Timossi, Luca; Guaglianone, Salvatore; Simone, Giuseppe; Papalia, Rocco; Gallucci, Michele; Puppó, P.

doi:10.1016/j.urology.2011.11.065

Cited by 13 publications

(8 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Four patients had received surgical replacement of the valve, while 4 patients (16%) had the device removed due to urethral cuff erosion. Similar results were described by Introini et al [16] in a recent retrospective series of 66 men with severe UI. The majority of patients (79%) were dry at follow-up, while 15% and 6% were improved or failed, respectively.…”

Section: Discussionsupporting

confidence: 91%

“…One could argue that the inclusion of such patients may lead to overestimation of the overall risk of complications. However, when we stratified patients on the bases of exposure to radiations, we observed an erosion rate of 26.8% among radiation-naïve patients, which is consistent with what has been reported by Lima et al [11] and significantly higher compared to the reports by Schiavini et al [9] and Introini et al [16]. …”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Long-Term Outcomes of the Implant of a Periurethral Constrictor for Stress Urinary Incontinence Following Radical Prostatectomy

et al. 2016

View full text Add to dashboard Cite

Objectives: To assess morbidity, effectiveness and quality of life (QoL) of implant of Silimed periurethral constrictor (PC) in a consecutive series of patients who had stress urinary incontinence following radical prostatectomy. Material and Methods: A prospective non-randomized study designed on patients who underwent implant of Silimed PC. Primary end point was postoperative morbidity and secondary end points were effectiveness of implant and QoL. We performed a sub-analysis of men who received previous radiation and we compared the subpopulation with radiation-naïve patients. Results: Nineteen patients (31.6%) received pelvic radiation therapy prior implant. All procedures were completed successfully with median operative time of 55 (IQR 50-62.5) min. We recorded 47 (78.3%) postoperative complications in 30 men. Twenty-three men (38.3%) developed urethral erosion at median follow-up of 27.5 (IQR 21-35) months, and 1 man (1.9%) had rectourethral fistula at 2 months. Risk of urethral erosion increased significantly among patients who received radiation (63.1 vs. 26.8%; p < 0.001). In 12 cases (20%), we recorded malfunctioning of the reservoir requiring replacement. Conclusion: The implant of Silimed device is not safe due to a high risk of urethral erosion. Careful patient selection and detailed counseling are mandatory when considering the implant of PC in adult patients.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Long-Term Outcomes of the Implant of a Periurethral Constrictor for Stress Urinary Incontinence Following Radical Prostatectomy

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Continence was recovered completely in 49 cases (79%), partially in 9 (15%) cases, and remained unchanged in 4 (6%). In 4 cases (6%) the device was removed because of infection/periurethral erosion [23].…”

Section: Malaeb Et Al Tested the Functionality And Biocompatibility mentioning

confidence: 99%

A novel urethra compression technique using Turkish continence device for male urinary incontinence

Odabaş¹,

Sancak²,

Kasap³

et al. 2020

Turk J Med Sci

View full text Add to dashboard Cite

Background/aim: The male sling operation and artificial urinary sphincter implantation are common methods for treating urinary incontinence. However, there are some drawbacks to these methods such as infection, urethral erosion, pain, inefficiency, and the technical difficulty of the operations. Here we describe a new device we have named the Turkish Continence Device (TCD) which has advantages over these other methods. The aim of this study was perform experiments with the TCD prototype in vivo and ex vivo to determine efficiency, convenience of implantation, and negative effects. Materials and methods: We implanted the prototype device in male goats and sheep, compressing the posterior urethra, and then fixed it by sutures on the lateral sides of the cavernosal bodies, bilaterally. Then we recorded urodynamic findings and performed urinary imaging. Additionally we measured urethral closure pressure ex vivo. Results: The balloon volume for efficient urethral closure pressure using the new device was under 1 mL. It compressed the urethra towards the corpus cavernosum perfectly, because the wings of the prototype device are fixed near the tunica of the cavernosal bodies on each side. Conclusion: A smaller device with smaller arms/wings would be efficient for obtaining enough pressure on the urethra. Additionally, the technique for implanting the device is very simple and would likely be learned quickly.

show abstract

“…The self-sealing valve was replaced successfully in 3 of the malfunctioning cases (4.5%). 25,26 Discussion SUI following RP has been described as a major adverse effect affecting quality of life and remains a daily challenge for urologists. After initial assessment, the first-line treatment is non-invasive, based on supervised pelvic floor muscle training.…”

Section: Periurethral Constrictormentioning

confidence: 99%

Incontinence after radical prostatectomy: Anything new in its management?

Caremel¹,

Corcos

2014

CUAJ

View full text Add to dashboard Cite

Introduction: With the increasing number of radical prostatectomies (RP) performed, male stress urinary incontinence (SUI) has become common. The artificial urinary sphincter (AUS) is the gold standard to treat SUI post-RP, but new devices have recently been developed. We review the recent studies on the treatment of SUI post-RP; we also describe the surgical techniques, mechanisms of action and results of these new procedures. Methods: We conducted a literature review search in the PubMed/ Medline and Embase databases. Our search was restricted to recent articles. We included studies even if the urinary incontinence was due to sphincter deficiency after RP in non-neurologic patients. Results: We found 8 cohort studies for the surgical procedure: 3 studies concerning slings, 1 involving balloons adjustable implant, and 4 involving new devices. The only randomized controlled trial (RCT) was a pharmacologic clinical trial comparing duloxetine to placebo. The social continence rates were analyzed for 6 studies and were up to 66%. Conclusion: New minimally invasive surgical procedures have emerged as the main alternative to AUS, with social continence rates up to 60% despite just 1 RCT studying the pharmacologic approach. There is an urgent need for well-designed clinical trials to clarify the role of new surgical alternatives in the management of SUI post-RP. New technologies should continue to be evaluated and compared with the AUS, which remains the gold standard.

show abstract

Safety and Efficacy of Periurethral Constrictor Implantation for the Treatment of Post–radical Prostatectomy Incontinence

Cited by 13 publications

References 12 publications

Long-Term Outcomes of the Implant of a Periurethral Constrictor for Stress Urinary Incontinence Following Radical Prostatectomy

Long-Term Outcomes of the Implant of a Periurethral Constrictor for Stress Urinary Incontinence Following Radical Prostatectomy

A novel urethra compression technique using Turkish continence device for male urinary incontinence

Incontinence after radical prostatectomy: Anything new in its management?

Contact Info

Product

Resources

About