[The surgical treatment of incontinence in the male (author's transl)].
The authors undertake a complete review of the various techniques used for the surgical treatment of urinary incontinence in the male. Urethral repair (Young operation) has been abandoned. Creation of a smooth muscle sphincter in bladder gives approximately 32% continence. Use of the anal sphincter to ensure continence of the urethra gives approximately 60% good results. Urethral or bladder neck suspension by aponeurotic strips have given only 42% good results. Perineal muscular plasty procedures resulting a certain compression of the urethra have given approximately 68% good results. Perineal prostheses, despite a certain number of complications (fistulae, infections, urethral erosions) give 37% good results when all the published series are grouped together. Continence prostheses (Scott or Rosen) have given the same percentage of favourable results: 60%. In this review, the authors report the 13 operations which they have performed with insertion of a Kaufmann prosthesis with, in the long term, 6 continent patients out of the 13. Radiological analysis of micturition in these patients with a good result would appear to suggest to the authors that the Kaufmann prosthesis does not act only by simple compression of the urethra but provides a still tonic urethra with a support which enables it to play a role in continence. So much so that the prior study of the efficacy of urethral compression could be used to choose between the insertion of a Kaufmann prosthesis or the immediate recourse to artificial sphincters.
D006801:Humans; D008297:Male; D010502:Perineum / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000601:surgery; D019736:Prostheses and Implants; D014521:Urethra / Q000601:surgery; D014549:Urinary Incontinence / Q000000981:diagnostic imaging / Q000601:surgery*; D014567:Urography
Traitement chirurgical de l'incontinence chez l'homme.