Item Number: 37381, 37387, 36812

Why is it done?

  • Male Stress incontinence/ Incontinence
  • Usually after a TURP/TUVP, Radical Prostatectomy in 2% of cases as pre-described complication of surgery

 

Pre-requirements

  • Informed consent is required from the patient and a pre-admission clinic will be arranged.
  • Patients may not eat or drink from midnight the previous evening.
  • Patients are to refrain from smoking before the procedure.
  • Patients allergic to IODINE/CHLORHEXIDINE should clearly state this at the pre-admission clinic as well as to theatre staff and Dr. Schoeman.
  • Any anti-coagulants such as Warfarin or Aspirin must be stopped 7 days prior to surgery. This may be replaced by once daily Clexane injections.
  • Pre-operative blood tests are required 4 days prior to surgery.
  • Patients with cardiac illnesses require a cardiologist/ physician report.
  • A chest X-ray is required for patients with lung disease.
  • Be prepared for a 2 night stay.

 

How is it done?

  • ·This procedure is done under a spinal /general anaesthetic, as decided by the anaesthetist.
  • The legs will be elevated into the lithotomy position.
  • A 7cm incision is made on the perineum space between scrotum and anus).  Or penoscrotal junction. You will also have a small suprapubic incision.
  • The silicone inflatable cuff is placed around the upper end of the corpora cavernosa of the penis.
  • The reservoir is placed behind the pubic bone
  • The access port is placed in the scrotum, make sure it is on the side of your dominant hand.
  • The cuff will only be activated 6 weeks after the surgery
  • The wounds are closed with dissolvable sutures and/or skin glue.
  • A local anaesthetic is given for pain relief.
  • A urinary catheter is placed for 24hrs.
  • The catheter will be removed early the next morning..
  • Prophylactic antibiotics will be given to prevent infection.

 

Complications

  • Any anaesthetic has its risks and the anaesthetist will explain all such risks.
  • Complications: hemorrhaging, requiring blood transfusion <1%;
  • Patients will wake up with a catheter in the urethra and bladder. This will remain in the bladder for 24 hrs.
  • Pelvic pain for 10-14 days may occur, making it difficult to sit.
  • You will be incontinent until the cuff is activated
  • This may less effective in irradiated patients

NB! Each person is unique and for this reason, symptoms may vary

What next?

  • Patients will have a trial of void without catheter the next day. You will be incontinent until the device is activated in 6 weeks
  • Patients will be discharged as soon as they can completely empty the bladder.
  • Patients may initially suffer from urge incontinence but this will improve within the next 6 weeks.
  • Allow 6 weeks for symptoms to stabilise.
  • Initial period of pelvic pain is expected.

 

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Copyright 2019 Dr Jo Schoeman