Mini-invasive collagen sling in the treatment of urinary incontinence due to sphincteric incompetence
| Autor: | Riitta Fagerholm, Risto Rintala, Seppo Taskinen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Sling (implant) Adolescent Swine Urinary Incontinence Stress Urology 030232 urology & nephrology Biocompatible Materials Urinary incontinence Epispadias lcsh:RC870-923 03 medical and health sciences Mini invasive surgery 0302 clinical medicine children medicine Animals Humans suburethral sling Child 030219 obstetrics & reproductive medicine Pelvic floor urinary incontinence business.industry lcsh:Diseases of the genitourinary system. Urology medicine.disease Extracellular Matrix 3. Good health Surgery Bladder exstrophy Catheter Treatment Outcome Urethra medicine.anatomical_structure neuropathic bladder Feasibility Studies Urologic Surgical Procedures Female Collagen medicine.symptom business Follow-Up Studies |
| Zdroj: | International braz j urol, Volume: 33, Issue: 3, Pages: 395-406, Published: JUN 2007 International braz j urol v.33 n.3 2007 International Braz J Urol Sociedade Brasileira de Urologia (SBU) instacron:SBU International Brazilian Journal of Urology, Vol 33, Iss 3, Pp 395-406 (2007) University of Helsinki |
| Popis: | OBJECTIVE: To assess the technical feasibility of mini-invasive sling procedure and present preliminary results in the treatment of urinary incontinence due to sphincteric insufficiency. MATERIALS AND METHODS: Thirteen patients (6 males, 7 females, 8 with myelomeningocele, 1 with tethered spinal cord, 3 with bladder exstrophy, 1 with epispadias) underwent sling procedure with porcine dermis acellular collagen matrix (PelvilaceTM, Bard medical, UK). The median age was 15.5 (range 8.9-27.5) years. A suprapubic catheter was inserted for the measurement of leak point pressure during the operation. In females vaginal and in males perineal incision was used for sling insertion. The sling was introduced under cystoscopic control. The sling was not fixed with sutures. The outcomes were reviewed at 1, 6 and 12 month after the operation. RESULTS: The median leak point pressure increased from 21.5 (range 5-25) cm H2O to 85 (range 70-100) cm H2O. At 1 month 8 and at 6 months 3 out of 13 patients were dry. At 12 months, none out of 11 patients was completely dry. However, at 12 months some improvement in incontinence was detected in 9 out of 11 patients. Two patients had primary failures. One patient got sling erosion to urethra after a tightening attempt. In one patient detrusor overactivity increased after the sling procedure. CONCLUSIONS: PelvilaceTM sling is safe and easy to introduce in both males and females if pelvic floor anatomy is normal. Although immediate results were promising in neuropathic incontinence, the results seem to deteriorate to unacceptable low level already during the first year. In exstrophy patients the results are generally poor. |
| Databáze: | OpenAIRE |
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