Surgical treatment of post prostatectomy incontinence
Authors:
R. Zachoval; M. Záleský; V. Borovička; P. Holý
Authors‘ workplace:
Primář: Doc. MUDr. Roman Zachoval, Ph. D.
; Urologické oddělení Thomayerovy nemocnice, Praha
Published in:
Prakt. Lék. 2014; 94(3): 120-125
Category:
Of different specialties
Overview
For several decades standard surgical treatment for patients with moderate to severe degree of incontinence has been an implantation of artificial urinary sphincters. Complication rate and possibility of surgical revision in patients with artificial urinary sphincter is relatively high and manual dexterity of patients for operating the system is demanded. That is why minimally invasive methods (sling procedures) are being used more often at present. Sling procedures seem to be suitable alternative for patients with mild to moderate degree of incontinence. They can also be used for severe degree of incontinence in patients preferring minimally invasive surgery although they have slightly inferior results. Implantation of periurethral bulking agents is suitable only for selected groups of patients as the long term results are not satisfying. High complication rate has been reported after adjustable balloon system implantation and therefore more data is needed to acquire. Implantation by means of transrectal ultrasound probe decreases the number of these complications. Stem cell therapy is not recommended at present.
Keywords:
incontinence – radical prostatectomy – artificial urinary sphincter – sling
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