Use of an occlusive penile clamp during filling cystometry in men with symptoms of stress urinary incontinence

This study evaluated cystometry and pressure flow studies (PFS) in men in whom severe SUI during attempted filling necessitated application of a penile clamp to allow filling to reach cystometric capacity. Men who had undergone prior radical prostatectomy were identified from a database of patients attending for video urodynamic testing between 2012 and 2017. Symptom scores, bladder diary and free flow rate tests were retrieved. Measurements of the subgroup of men for whom a Thomson‐Walker compression clamp was used to enable full urodynamic evaluation were evaluated. 166 patients were identified. In 30 patients (18%), severe SUI led to incomplete filling cystometry. Following application of the penile compression clamp, further filling was achieved in each case. Applying the clamp did not alter vesical filling or impede pressure recording. These men had a lower maximum urethral closure pressure (31.6 vs. 46.5 cm H2O;P
Source: LUTS: Lower Urinary Tract Symptoms - Category: Urology & Nephrology Authors: Tags: ORIGINAL ARTICLE Source Type: research

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CONCLUSIONS: According to our review no technique may be considered better than the other when treating large adenomas. Studies are still lacking to prove long term efficacy and future studies should clarify the role of prostatic artery embolization and minimally invasive simple prostatectomy in the management of prostates larger than 80 ml. PMID: 31619035 [PubMed - as supplied by publisher]
Source: Minerva Urologica e Nefrologica - Category: Urology & Nephrology Tags: Minerva Urol Nefrol Source Type: research
Authors: Huh JS, Kim YJ, Kim SD, Park KK Abstract PURPOSE: To analyze the clinical parameters correlated with early recovery of urinary continence after radical prostatectomy, with a focus on urethral mobility during pelvic contraction at catheter removal. METHODS: We prospectively analyzed 67 patients who underwent prostatectomy for prostate cancer at Jeju National University Hospital from January 2015 to June 2018. At the time of catheter removal, a cystography was performed in 67 men (median age, 65 years; range, 55-76 years) who had undergone robot-assisted laparoscopic prostatectomy. The vertical length of...
Source: International Neurourology Journal - Category: Urology & Nephrology Tags: Int Neurourol J Source Type: research
Authors: Ko KJ, Kim SJ, Cho ST Abstract The management of postprostatectomy urinary incontinence (PPI) is still challenging for urologists. In recent decades, various kinds of male sling system have been developed and introduced; however, they have not yet shown as good a result as that of artificial urinary sphincter (AUS). However, a male sling is still in an important position because patients have a high demand for sling implantation, and it can allow the avoidance of the use of mechanical devices like AUS. Recently, the male sling has been widely used in mild-to-moderate PPI patients; however, there are no stu...
Source: International Neurourology Journal - Category: Urology & Nephrology Tags: Int Neurourol J Source Type: research
AbstractBackgroundTo comprehensively evaluate the efficacy and safety of Retzius sparing (RS) for men undergoing robot-assisted laparoscopic prostatectomy (RARP).MethodsWe searched four electronic databases and reference lists of relevant studies for eligible research published before March 11, 2019. After quality assessment, eligible studies were synthesized for relevant outcomes, including positive surgical margin (PSM), continence, incontinence, complication, console time, and hospital stay.ResultsTwo randomized clinical trials and four observational studies were included in this study. Quantitative syntheses revealed s...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
This study was conducted to evaluate the Advanced Reconstruction of Vesicourethral Support (ARVUS), a novel postprostatectomy reconstruction technique.MethodsThe study was designed as a prospective, controlled, partially randomized and blinded experiment. The statistical analysis was based on the generalized linear modeling (GLM) framework with random effects: the logit link was used to model the probability of achieving continence and the logarithmic link was used to evaluate the overall score of the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). The significance of the fixed effects and al...
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
CONCLUSIONS: The reconstruction of the rhabdosphincter is the only technique that has shown improved functional results through randomized trials. The current evidence is limited and heterogenous, and more studies with consistent criteria are needed in order to establish a standard surgical technique. PMID: 31606163 [PubMed - as supplied by publisher]
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Authors: Tags: Actas Urol Esp Source Type: research
CONCLUSIONS: Following sling implantation, modifications in UPPs were observed, with increases in MUCP and FUL but these increments were not statistically significant. Limitations to our study include biases inherent to the interpretation and reproducibility of urethral profilometry, the sample size, and the variable delay between sling implantation and postoperative urodynamic studies. LEVEL OF EVIDENCE: 4. PMID: 31587866 [PubMed - as supplied by publisher]
Source: Progres en Urologie - Category: Urology & Nephrology Tags: Prog Urol Source Type: research
CONCLUSION: This multicentric retrospective series confirms that male slings are a usefull therapy for patients with mild or moderate urinary incontinence. LEVEL OF EVIDENCE: 4. PMID: 31587865 [PubMed - as supplied by publisher]
Source: Progres en Urologie - Category: Urology & Nephrology Tags: Prog Urol Source Type: research
ConclusionAchievement of urinary continence and improvement of urinary quality of life are delayed in patients with preoperative urinary incontinence assessed by the 1-h pad test. The preoperative 1-h pad test could be a useful predictor of prolonged urinary incontinence and poor quality of life after robot-assisted radical prostatectomy.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
AbstractRobotic-assisted simple prostatectomy (RASP) has emerged as a safe and effective treatment option for symptomatic patients with lower urinary tract symptoms related to significant benign prostatic enlargement (BPE) above 80  g. The recent release of the da Vinci SP robotic system (Intuitive, Sunnyvale, CA, USA) continues to advance the minimally invasive nature of robotic surgical technology. We now report our institution’s initial experience performing RASP using the da Vinci SP robotic system. An IRB-approved, ret rospective chart review was performed of all patients undergoing robotic-assisted simple ...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research
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