male sling

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13. Male perineal sling with autologous aponeurosis and bone fixation - description of a technical modification

  • Luis A.S. Rios; Rodrigo T. Tonin; Renato Panhoca; Osmar E.R. de Souza; Limrio L. da Fonseca Filho; Demerval Mattos Jr. Department of Urology, State Civil Servant's Hospital, So Paulo, SP, Brazil

14. Male perineal sling with autologous aponeurosis and bone fixation - description of a technical modification

  • Luis A.S. Rios; Rodrigo T. Tonin; Renato Panhoca; Osmar E.R. de Souza; Limrio L. da Fonseca Filho; Demerval Mattos Jr. Department of Urology, State Civil Servant's Hospital, So Paulo, SP, Brazil

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18. Male slings for postprostatectomy incontinence. CespedesRD ,Jacoby K . Department of Urology (MCSU), Wilford Hall Medical Center, Lackland, AFB, Texas 78236, USA.

  • PURPOSE: Over the past few years, there has been increasing interest in using male slings for postprostatectomy incontinence (PPI). Currently, three different forms of the male sling has been described: one using synthetic materials and two using human fascia or dermis. This article will give a historical perspective on the male sling and describe the surgical techniques and early results using two different types of male slings using fascia or dermis. MATERIALS AND METHODS: From 1997 to 1999, nine patients with PPI underwent a bladder neck sling procedure using a combined perineal and abdominal approach. All patients had a suprapubic incision to expose the rectus muscle and to place a suprapubic tube. Since 1999, we have used a wide cadaveric fascial or dermal sling placed at the proximal bulbar urethra. Using an entirely perineal approach, the sling ends are fixated to the inferior pubic rami using bone anchors. RESULTS: Of 9 patients with bladder neck slings, 6 are dry, 1 is significantly improved, and 2 have failed, at a mean follow-up of 13 months. For the perineal male sling, 26 (45%) of 58 patients were completely dry, and overall 47 (81%) of 58 were significantly improved or were dry at a mean 6 months postoperatively. Neither group had significant complications. CONCLUSIONS: Both male slings appear to be safe and effective procedures for treating PPI; however, longer follow-up and additional experience are needed to determine their true role in the treatment of PPI.

19. The male sling for stress urinary incontinence: a prospective study. ComiterCV . University of Arizona Health Science Center and the Southern Arizona Veteran's Administration Healthcare Center, Tucson, Arizona, USA.

  • PURPOSE: This is a report of a prospective study of the male sling for treating stress urinary incontinence. MATERIALS AND METHODS: A total of 21 men underwent sling surgery. There were 2 titanium screws loaded with polypropylene suture placed in each descending pubic ramus through a 3.5 cm. perineal incision at the level of the bulbar urethra. A polypropylene mesh was placed over the urethra and tied to the bone anchors, adjusting sling tension to a compression pressure of 60 cm. water. Followup was done with the incontinence section of the University of California, Los Angeles/RAND Prostate Cancer Index. RESULTS: Mean followup was 12 months (range 5 to 21). Overall, incontinence was cured in 16 (76%) patients, substantially improved (stress urinary incontinence very small or small problem, 1 pad daily) in 3 (14%), somewhat improved (moderate problem-2 pads) in 1 and procedure failed (no improvement) in 1 (5%). The patients with stress urinary incontinence after undergoing transurethral prostatectomy were cured, as was the individual with myelomeningocele. Of the 18 patients with stress urinary incontinence after radical prostatectomy 13 were cured, including 1 of 2 who underwent previous artificial urinary sphincter placement and 2 of 3 adjuvant radiation. There was significant improvement in each survey question, and the total score improved from a mean plus or minus standard deviation of 65 +/- 11 preoperatively to 397 +/- 29 postoperatively