下部尿路の尿流動態研究 : IV Silicone Gel Prosthesis植込みによる尿失禁防止手術の経験

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A silicone gel prosthesis, reported by Kaufman in 1973 for the urinary anti-incontinence operation, has been implanted in 3 patients. Case 1: An 8-year-old boy complained of continuous dribbling of urine owing to congenital malformation of the external sphincter. The postoperative distension of prosthesis following the implantation was performed in 2 occasions with 7 ml of contrast medium. The maximum urethral pressure is presently 52 mmHg and the result is good. Case 2 : A 27-year-old man with a traumatic urethral rupture. The silicone gel prosthesis was implanted after transurethral resection of massive fibrosis at the posterior and bulbous urethra. The postoperative infusion of 8 ml contrast medium failed to increase the maximum urethral pressure above 30 mmHg. A penile clalhp is necessitated ; poor result. Case 3 : A 42-year-old man with a traumatic urethral rupture. The sling operation at the anterior urethra was previously attempted in vain using the fascia of rectus muscle. The postoperative distension of prosthesis with 10 ml of contrast medium following the implantation was not sufficient to prevent the incontinence completely. The amplitude of the maximum urethral pressure remained at 28 mmHg; poor result. While the immediate postoperative results were excellent in all cases, the compression effect started to deteriorate in about one week after operation. The fall of compression strength had to be compensated by the infusion of contrast medium up to 10 ml. It is speculated that the dissipation of local edema and/or elongation of ischiocavernosus muscle and Dacron-velour straps are responsible for this change.
社団法人日本泌尿器科学会の論文
1978-07-15

下部尿路の尿流動態研究 : IV Silicone Gel Prosthesis植込みによる尿失禁防止手術の経験

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