The Male Perineal Sling: Assessment and Prediction of Outcome

Fischer, M; Huckabay, Chad; Νitti, Victor W.

doi:10.1016/j.juro.2006.11.061

Cited by 83 publications

(65 citation statements)

References 19 publications

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“…Only the severe incontinent subgroup (24h pad test >400g) showed significantly less displacement of the anterior bladder neck than the continent group during contraction (p=0.022). These ultrasound findings are consistent with the literature and may explain the surgical results of the study by Fischer, et al (15).…”

Section: Discussionsupporting

confidence: 92%

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Parameters of two-dimensional perineal ultrasonography for evaluation of urinary incontinence after Radical Prostatectomy

et al. 2014

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ARTICLE INfO ______________________________________________________________ ______________________Introduction: Urinary incontinence remains a major concern for patients undergoing radical prostatectomy. Its prevalence can reach 20% in the late postoperative period. Materials and Methods:This clinical study investigated the differences of a dynamic evaluation of the urethra and pelvic floor contraction using perineal ultrasound in men without prostate surgery and in men submitted to radical prostatectomy with and without stress urinary incontinence. Ninety two male patients were included, which 70% of them underwent radical prostatectomy (RP) for more than one year. Thirty one men with clinically post prostatectomy incontinence were compared by two-dimensional (2D) perineal ultrasound to 34 patients without post prostatectomy incontinence and to 27 men without surgery in two centers in Brazil. Results: Our results showed that the continent group presented the urethral angle at rest significantly lower than the prostate group (p = 0.0002). We also observed that the incontinent group showed the displacement of the anterior bladder neck during contraction significantly lower than the continent group (p = 0.008). Conclusions:We found that the continent group presented the urethral angle at rest significantly lower than the prostate group. The incontinent group also showed the anterior bladder neck displacement during contraction significantly lower than the continent group. It was more evident when the severe incontinent group and the continent group were compared.

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Section: Discussionsupporting

confidence: 92%

“…However, several studies have shown that patients with severe incontinence did not obtain results as satisfactory as those patients with mild to moderate incontinence (21-23). Fischer et al observed in 62 patients, those who had a 24h pad test <423g showed a success rate six times higher than those who had a test >423g (15).…”

Section: Discussionmentioning

confidence: 95%

Parameters of two-dimensional perineal ultrasonography for evaluation of urinary incontinence after Radical Prostatectomy

et al. 2014

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“…The sling is increasingly being applied. The known effects are primarily short term: 40-90% need one or fewer pads per day and 16-76% require no incontinence material after an average of 12-18 months [10][11][12] . Bulking agents have shown reasonable short-term results.…”

Section: Introductionmentioning

confidence: 99%

ProACT™ for Stress Urinary Incontinence after Radical Prostatectomy

Martens

Lampe

Heesakkers³

2009

Urol Int

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Introduction: Stress urinary incontinence is a bothersome complication of radical prostatectomy. Surgical treatment consists of the artificial urinary sphincter (AUS), the male sling and bulk injections. This study presents the results of the first series of implantations of ProACT^TM in the Netherlands. Materials and Methods: A non-validated questionnaire was sent to 29 male patients implanted with ProACT to determine Stamey score, pad count and questions about quality of life and satisfaction. Complications, revisions and explantations were registered. Results: Mean follow-up was 41 months. Based on Stamey score four patients are continent at the end and nine patients according to the pad count. The average pad count decreased significantly. Remarkable was the high rate of dislocations and revisions and patients’ satisfaction. Conclusions: ProACT is a less invasive treatment compared to the AUS. However, the procedure is associated with a substantial revision and explantation rate. ProACT can be part of a so-called step-up approach before opting for a more invasive treatment.

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“…Published success rates range from 38 to 76% depending on the outcome measures used. The most common complications are infection and temporary urinary retention [17,18,19]. Less common complications include persistent urinary retention (3% rate) and erosion of the sling into the urinary tract (2% rate) [18].…”

Section: Discussionmentioning

confidence: 99%

Geometrical Stepper-Guided Navigation System for ProACT Implant under Transrectal Ultrasound Control: Preliminary Data

et al. 2012

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Purpose: To describe a new geometrical stepper-guided navigation system for positioning ProACT®. Methods: The sizing of the stepper-guided navigation system was calculated using the distance from the ideal position of the device to anatomic referral points previously measured by ultrasound. The trocar and subsequently the device were maneuvered to the ideal position in accordance with the navigation system. Measurements: Treatment efficacy was evaluated with daily pad count, 1-hour pad test, Incontinence Quality of Life questionnaire (IQoL), visual analog scale and overall impression. Complications, balloon volume and number of adjustments were reported at 1, 3, 6 and 12 months follow-up visits. Results: Mean follow-up was 12 (range 3–19) months. Daily pad count showed 30 patients (71%) dry and 9 patients (21%) improved. 1 hour pad test showed 28 patients were dry (66%) and 11 patients improved (26%). IQoL increased from an average of 35.3 to 80. Average visual analog scale score was 8. Complications requiring device removal occurred in 3 patients (7%). Mean balloon volume was 3.1 ml. Conclusions: The stepper-guided navigation system to implant ProACT is feasible and extremely reproducible making this procedure more standardized.

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The Male Perineal Sling: Assessment and Prediction of Outcome

Cited by 83 publications

References 19 publications

Parameters of two-dimensional perineal ultrasonography for evaluation of urinary incontinence after Radical Prostatectomy

Parameters of two-dimensional perineal ultrasonography for evaluation of urinary incontinence after Radical Prostatectomy

ProACT™ for Stress Urinary Incontinence after Radical Prostatectomy

Geometrical Stepper-Guided Navigation System for ProACT Implant under Transrectal Ultrasound Control: Preliminary Data

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