[Stress urinary incontinence after radical cystectomy: neobladder construction and placement of the functional retrourethral sling].
Stress urinary incontinence (SUI) following radical cystectomy and orthotopic ileal neobladder construction represents a challenging problem. The incidence of incontinence following this surgery is reported to be 30-60% and is - despite a better understanding of the male (and female) pelvic anatomy - still regarded as an adverse outcome of this surgery.Therapeutic options have been limited up until now and include pharmacological agents, surgical treatment and pelvic floor training with only moderate amelioration of the symptoms and often unacceptable side effects. Nevertheless, urinary continence is probably the most important key to patient satisfaction. Here we introduce the perineal approach of the functional retrourethral mesh as a new and innovative sling suspension based on a non-obstructive procedure in a patient with urinary stress incontinence after ileal neobladder. The sling adjusts the changed anatomy after radical cystectomy returning it to the former preoperative position and thus continence can be achieved again. The approach of the sling in a patient with ileal neobladder is safe and the good result concerning continence is promising.
Mayer
M
M
Urologische Klinik und Poliklinik, Klinikum der Universität München - Campus Grosshadern, Ludwig-Maximilians-Universität, Marchioninistrasse 15, 81377, München, Deutschland. margit.mayer2@med.uni-muenchen.de
Bauer
R M
RM
Walther
S
S
Becker
A J
AJ
Stief
C G
CG
Bastian
P J
PJ
Gozzi
C
C
D015653:Cystectomy / Q000009:adverse effects*; D004312:Douglas' Pouch / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014547:Urinary Diversion / Q000295:instrumentation / Q000379:methods*; D014550:Urinary Incontinence, Stress / Q000209:etiology* / Q000601:surgery*