Synchronous management of anastomotic contracture and stress urinary incontinence following radical prostatectomy.
Of 77 patients presenting for artificial urinary sphincter implantation due to incontinence following radical prostatectomy 26 had a significant associated urethrovesical anastomotic contracture. Synchronous endoscopic contracture incision with electrocautery and implantation of an artificial urinary sphincter (AMS800) were performed in all cases. A total of 25 patients void with a good subjective flow, with an average followup of 32 months. In 1 patient symptomatic stenosis recurred 6 months after incision and reincision was successful at the time of sphincter revision. No infection or erosion developed and 24 patients are socially continent (0 to 1 thin pad per day). During this time 5 patients underwent 8 revisions of the artificial sphincter. Synchronous contracture incision with electrocautery and artificial urinary sphincter implantation are safe and provide satisfying results in patients with complex post-prostatectomy incontinence.
Mark
S
S
Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina 27710.
Pérez
L M
LM
Webster
G D
GD
D000714:Anastomosis, Surgical / Q000009:adverse effects; D003251:Constriction, Pathologic; D004564:Electrocoagulation; D006801:Humans; D008297:Male; D011468:Prostatectomy / Q000009:adverse effects*; D014521:Urethra / Q000473:pathology / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*; D016741:Urinary Sphincter, Artificial