The use of autologous fascia in the Mini-Jupette graft: two cases

Towe, Maxwell; El‐Khatib, Farouk M.; Osman, Mohamad M.; Choi, Jong-Woo; Yafi, Faysal A.

doi:10.1038/s41443-019-0178-z

Cited by 5 publications

(6 citation statements)

References 6 publications

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“… (range: 15–130 mo.) Valenzuela et al, 2019 75 31109775 Male Urethral Mini-Sling (MUMS) 36 Retrospective review of those with history of IPP and MUMS placement for climacturia (9), SUI (6) or both (21) Subjective improvement in SUI, Changes in pre-op vs post-op pads per day Subjective success: 85% Mean # of pads decreased from 1.4 (pre-surgery) to 0.4 (post-surgery) (p = 0.02) 59% Explant for erosion: 1 (2.8%) Transient urinary retention: 5.6% Mean 5.9 ± 3.7 mo. Ye et al, 2018 65 30404760 AdVance Sling 113 Prospective multicenter study on post-prostatectomy patients Cure: 0 pads and no urinary leakage Improvement: >50% leakage reduction and no more than 1 pad 80.6% 22.6% No direct device removal/revision Clavien IIIb complications: 2.7% (1 perineal hematoma, 1 perineal abscess, 1 urethral perforation) 93 attended all post-op visits (1.5, 3, 6, 12, 24 mo.)…”

Section: Devices Currently Available In the Usmentioning

confidence: 99%

Surgical Management of Male Stress Incontinence: Techniques, Indications, and Pearls for Success

VanDyke¹,

Venishetty²,

Langford³

et al. 2023

RRU

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Purpose Male stress urinary incontinence (SUI) has detrimental and long-lasting effects on patients. Management of this condition is an evolving field with multiple options for surgical treatment. We sought to review the pre-operative evaluation, intra-operative considerations, post-operative care, and future directions for treatment of male SUI. Methods A literature review was performed using the PubMed platform to identify peer-reviewed, English-language articles published within the last 5 years pertaining to management of male stress urinary incontinence with an emphasis on devices currently on the market in the United States including the artificial urinary sphincter (AUS), male urethral slings, and the ProACT TM system. Patient selection criteria, success rates, and complications were compared between the studies. Results Twenty articles were included in the final contemporary review. Pre-operative workup most commonly included demonstration of incontinence, PPD, and cystoscopy. Definition of success varied by study; the most common definition used was social continence (0–1 pads per day). Reported rates of success were higher for the AUS than for male urethral slings (73–93% vs 70–90%, respectively). Complications for these procedures include urinary retention, erosions, infections, and device malfunction. Newer treatment options including adjustable balloon systems and adjustable slings show promise but lack long-term follow-up. Conclusion Patient selection remains the primary consideration for surgical decision-making for management of male SUI. The AUS continues to be the gold standard for moderate-to-severe male SUI but comes with inherent risk of need for revision. Male slings may be a superior option for appropriately selected men with mild incontinence but are inferior to the AUS for moderate and severe incontinence. Ongoing research will shed light on long-term results for newer options such as the ProACT and REMEEX systems.

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Section: Devices Currently Available In the Usmentioning

confidence: 99%

Surgical Management of Male Stress Incontinence: Techniques, Indications, and Pearls for Success

VanDyke¹,

Venishetty²,

Langford³

et al. 2023

RRU

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“…30,31 In the context of autologous fascia utilization, Towe et al published a case series of two patients who underwent robotic-assisted RP and presented with concomitant ED, SUI, and climacturia. 32 Both patients were treated with IPP and Mini-Jupette graft placement. For the Mini-Jupette graft construction, autologous rectus fascia was harvested during the procedure.…”

Section: Autologous Mini-jupette Slingmentioning

confidence: 99%

The ‘Mini-Jupette’ technique for climacturia: a systematic review

Ioannis,

Stavros,

Eliophotos

et al. 2023

Therapeutic Advances in Urology

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Background: The leakage of urine during sexual arousal, known as climacturia, is an under-recognized clinical condition often overshadowed by erectile dysfunction in men who have undergone radical prostatectomy. Objectives: This study aims to determine and evaluate the role of the Mini-Jupette technique and its alternatives in the treatment of climacturia. Data sources and methods: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. We searched Medline via PubMed, Scopus, and the Cochrane Library databases until October 2022. Results: We included seven studies involving 120 patients with climacturia. Different types of grafts were used, ranging from synthetic mesh to autologous grafts. In all seven studies, the use of the Adrianne Mini-Jupette (AMJ) and its alternatives showed a high percentage of improvement in climacturia, with reported complete resolution ranging from 65% to 93%. Regarding postoperative complications, one study reported the highest sling explantation rate at 11% (4/38), while other studies reported complications ranging from subjective symptoms such as dysuria and perineal pain to the need for subsequent artificial urinary sphincter placement. Conclusion: The AMJ sling and its variations are low-cost, time-efficient, and relatively safe procedures with high patient satisfaction rates among those treated for climacturia.

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“…In a later report, Yafi expressed preference for the polypropylene glycol Restorelle® graft (Coloplast Corp, Minneapolis, MN, USA), given its relative availability and approval for use in female urethral procedures [46]. Given the concern of mesh complications, Towe et al [49] recently published a report of two patients who underwent autologous rectus facial graft, both of whom saw resolution of climacturia at 4-month follow-up.…”

Section: Mini-jupette Slingmentioning

confidence: 99%

“…Surgical trials and series published for treatment of climacturia are summarized in Table 2 (Ref. [45,[48][49][50][51][52][53][54]).…”

Section: Male Urethral Slingmentioning

confidence: 99%

Contemporary Management of Post-Prostatectomy Climacturia: A Review

Chestnut¹,

Hehemann²

2022

JOMH

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Climacturia is estimated to effect approximately 30% of men after radical prostatectomy and has significant impact on patient quality of life. In this narrative review, our aim is to describe the pathophysiology of climacturia, its predictive factors, and the existing conservative and surgical treatment options in the modern era. Peer-reviewed publications on the post-prostatectomy climacturia were identified through a PubMed search, with terms included climacturia, arousal incontinence, post prostatectomy incontinence, orgasm and radical prostatectomy. While the pathophysiology of climacturia remains poorly understood and predictive factors poorly elucidated, men experiencing climacturia often report significant bother and reduction in quality of life. Various treatment options have been investigated for this condition, with conservative measures including pelvic floor physical therapy and variable penile tension loops, and operative strategies including the Mini-Jupette and traditional bladder slings. As providers of comprehensive urologic care for prostate cancer survivors, it is incumbent upon urologists to query patients about bothersome climacturia and offer these evidence-based treatment options.

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The use of autologous fascia in the Mini-Jupette graft: two cases

Cited by 5 publications

References 6 publications

Surgical Management of Male Stress Incontinence: Techniques, Indications, and Pearls for Success

Surgical Management of Male Stress Incontinence: Techniques, Indications, and Pearls for Success

The ‘Mini-Jupette’ technique for climacturia: a systematic review

Contemporary Management of Post-Prostatectomy Climacturia: A Review

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