I-Stop Tomps sling for male incontinence: first experience on 20 cases
Despite the experience and improvement of laparoscopic or robotic surgical techniques the postoperative urine leakage is a always present problem.
A suburethral sling is indicated in patients suffering from mild stress urinary incontinence media after radical prostatectomy.
The surgery is performed under lumbar anesthesia. A 4-cm longitudinal incision over the bulbar urethra is done. Preparation of the urethra while preserving the muscle bulb cavernosum. Liberation of the median raphe of the bulbar area in order to relocate the cervico- urethral area in the pelvis. Preparation of two triangular spaces bounded by the urethra and lateral crura . Two small incisions 2 cm below the longus adductor muscle through which the needles are applied with out- in technique. The tip of the needle must emerge from the top of the previously made triangle to attract bilaterally the sling . Fixation of the sling at urethra with four stiches on prolene 3/0, and after pulling the upper and lower arms, anchor sling to the crura with two stiches on prolene 3/0 . Suture of skin and subcutaneous with running stich of vicryl 3/0 . Not drainages are left. The urethral catheter is removed the next day and the patient discharged.