Pressure assessment in intercavernous embedding of bulboperineal urethra for treatment of urinary incontinence after prostatic operation.
OBJECTIVE
To put forward criteria for the pressure assessment in the operation of intercavernous embedding of bulboperineal urethra for the treatment of urinary incontinence after prostatic operation.


METHODS
A F14 urethral catheter is inserted during the operation and upon suturing the corpora cavemosa centrally, the catheter is slowly pushed in and pulled out in order that the operator feels a certain degree of close-fit resistance. The degree of tightness of the stitches, which regulate the compression pressure, is adjusted in accordance with this close-fit sensation. To further ascertain the adequacy of the force of compression, the bladder is filled with 300 ml physiological saline and observe the appropriateness (size and continuity) of the outflow stream when the lower abdomen is depressed with a pressure of 80-90 cm H2O. The operation was given to six patients suffered from urinary incontinence for 20 or more months after prostatic operation.


RESULTS
Five cases achieved complete recovery, while the therapeutic effect of the 6th one was not satisfactory. A second stage operation was carried out 3 months later with the addition of one more stitch both proximally and distally to reinforce the compression force. The condition was improved dramatically. The follow-up period averaged 3.5 years.


CONCLUSIONS
The adequacy of the compression pressure exerted by the juxtaposed corpora cavernosa is the key point determining the outcome of the operation. The measures for assessing the compression pressure suggested by the authors are helpful in obtaining the good results of the present paper (6/6 success) as compared with 25/34 success in the previous report.
Qian
L X
LX
Department of Urology, First Affiliated Hospital, Nanjing Medical University, China. qianlx@jlonline.com
Wu
H F
HF
Shui
Y G
YG
Zhang
W
W
Cheng
S G
SG
Gu
M
M
Xu
Z Q
ZQ
D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011312:Pressure; D011470:Prostatic Hyperplasia / Q000601:surgery*; D014521:Urethra / Q000601:surgery*; D014546:Urinary Catheterization / Q000379:methods; D014549:Urinary Incontinence / Q000601:surgery*; D014563:Urodynamics; D013521:Urologic Surgical Procedures, Male / Q000379:methods