[Post-TUR-P stress urinary incontinence successfully treated by periurethral injection of autologous fat to the prostate: a case report].
A 77-year-old man had been suffering from stress urinary incontinence for 2 years since he had received transurethral resection of prostate (TUR-P) for benign prostatic hypertrophy. A 60-min pad test yielded 3 g of urine. Prostatic urethra was widely open and the external sphincteric injury was suggested because of the short membraneous urethra on the urethrogram. Urethral pressure profile indicated his maximal urethral closing pressure (MUCP) of 24 cmH2O and functional urethral length of 1.6 cm and cystometry demonstrated an underactive bladder, indicating that his incontinence was caused by sphincteric injury. Autologous fat injection therapy was performed in the lithotomy position under spinal anesthesia. Fifteen ml of subcutaneous fat was obtained from his lower abdomen by liposuction through a 15G needle, and 10 ml was injected submucosally from the perineum at 6 o'clock area of the prostatic apex under the guidance of transrectal echography using a 15G needle. The patient became completely dry after the procedure. MUCP and FUL increased to 35 cmH2O and 1.9 cm, respectively, although longer follow up is necessary. The advantage of autologous fat injection to the prostate for post-TUR-P SUI patients is briefly discussed.
Ishizaka
K
K
Department of Urology, Tokyo Medical and Dental University School of Medicine.
Koga
H
H
Kamata
S
S
Nagamatsu
H
H
Yamada
T
T
D000273:Adipose Tissue / Q000637:transplantation*; D000368:Aged; D006801:Humans; D007267:Injections; D008297:Male; D011183:Postoperative Complications; D011468:Prostatectomy / Q000009:adverse effects*; D011470:Prostatic Hyperplasia / Q000601:surgery; D014182:Transplantation, Autologous; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000628:therapy*