Objectives: We evaluated retrospectively, the long-term outcome of patients with post-prostatectomy urinary incontinence (PPUI) after placement of the Periurethral Constrictor (PUC). Materials and Methods: Fifty-six men with severe PPUI were studied, with a mean age of 68.5 years old. Fifty-one men had PPUI due to radical surgery having the device placed around the bulbous urethra, and five individuals with benign prostatic hypertrophy (BPH) had placement around the bladder neck. The mean follow-up was 82.2 months. Results: Twenty-two patients (39.28%) became continent (0 to 1 pad a day) and 34 (60.72%) were incontinent. Complications were as follows: urethral erosion in 15 (26.78%); mechanical malfunction in 2 (3.5%); infection in 2 (3.5%); urinary fistula in 1 (1.7%); Urinary tract infection1 (1.7%). Twenty-three patients needed to have the device removed (41.07%). Success rate (continent me) was 30.35%. Conclusion: In the present series the PUC was not effective for the treatment of severe PPUI in the long-term follow-up.
Purpose: The objective of the present study is to test the efficiency and practicality of a new artificial sphincter “BR - SL - AS – 904” in the control of urinary incontinence in post - PR patients and to evaluate their complications. Patients and Methods: Fifteen patients with incontinence after one year of radical prostatectomy were included prospectively. All patients underwent artificial urethral sphincter (AUS) implant “BR - SL - AS – 904” according to established technique. Independent variables such as free urinary flow, PAD weight test, ICIQ - SF score and urinary symptoms through the IPSS score were compared in different follow-up moments. Results: Patients submitted to AUS implantation did not present trans - operative or post - operative complications related to the surgical act such as: infection, hematoma, erosion or urinary retention. Device was inert to the body during the follow-up, showing an excellent adaptation of the patients, besides the easy handling. The mean age was 68.20 years 40% of the patients had systemic arterial hypertension, 6.7% diabetes mellitus, 6.7% were hypertensive and diabetic, 13.4% were hypertensive, had diabetes and hypercholesterolemia and 26.7% patients had no comorbidities. It was evidenced that the urinary flow peak during the follow-up remained stable. Decreased averages and median PAD weight test were 135.19 to 75.72 and 106.00 to 23.50, respectively. The IPSS score decreased and the quality of life increased (12.33 to 3.40 and 2.50 to 3.20 respectively). The ICQF - SF questionnaire score also showed a decrease, ranging from 16, 71 to 7.33. Conclusion: The artificial sphincter implant “BR - SL - AS 904” was reproducible, safe and effective in the control of urinary incontinence in post - PR patients.
Introduction: Percutaneous approach to the kidney is a very useful alternative in renal surgery which minimizes the morbidity of a variety of procedures. Objectives: To evaluate the efficacy, practicity of a reusable system of metallic coaxial dilator coupled to a special puncture needle to perform lumbar puncture and dilation of the percutaneous tract. Methods: A randomized experimental study was carried out involving 50 individuals. These patients were randomized as follows: Group 1 had the procedure performed with the conventional disposable Amplatz set traditionally used for this procedure. Patients in Group 2 were operated utilizing the new reusable coaxial set specially designed for this purpose. The following parameters were measured to compare the 2 groups: sex Corporeal Mass Index (CMI), Pre and postoperative hematocrit and hemoglobin. Time interval between the puncture, dilation and access to the renal pelvis and insertion of the nephroscope were also analyzed. Results: There was no statistical difference between the 2 groups concerning hematocrit and hemoglobin changes when comparing pre-with postoperative period. Patients in Group 2 required a significant lower time between puncture and final access to the upper collecting system. Conclusion: The new coaxial dilator set showed to be as safe as the conventional Amplatz set with the advantage of reusability and decrease of tract dilation time.
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