Abstract
Objective: To find optimal size of hydrogel implants and to standardize application methods in male with stress incontinence. Methods: In group of 12 male with stress urinary incontinence of different etiology swelling implants of two sizes made of 2-hydroxyethylmethakrylate were administered.
Patients were divided into three groups according the method of implantation: 1. transperineal needle approach below the sphincter under endoscopic control, 2.through perineotomy into bulbar corpus spongiosum, 3. the same as method 2 with insertion of corpus spongiosum between corpora cavernosa. We evaluated subjective status, uroflowmetry, pad weight test, cystometry, profilometry and postvoided volume of urine.
Results: In the first group of 7 patients after implantation of small implants there were no peroperative and postoperative complications. In the second group bigger implants were administered in eight patients.
In four of them it was a first implantation, while another four patients underwent reimplantation after failure of small implants. We recorded complications (infection of urinary tract, leak of implants through urethra, erosion of implants into urethra, urethral diverticulum, urethrospongeous fistula with sepsis and paravesical abscess formation).
There was only one patient in the third group. No peroperative and postoperative complications were recorded.
Subjective improvement was recorded in 1 patient from the first group and in 3 in the second group, impairment in 1 patient from the 2 group, no change in the rest. Full continence was not achieved in our group.
There was not good correlation with objective results. Conclusion: We demonstrated failure of implantation of hydrogel swelling implants as a treatment of stress incontinence in male.
We do not recommend further development of this method.