Urinkontinenz nach totaler Prostatektomie: Der urodynamische Beweis einer anatomischen Hypothese. [Urinary continence after radical prostatectomy: the urodynamic proof of an anatomical hypothesis (author's transl)]

Détails

ID Serval
serval:BIB_25DDA09CBC28
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Urinkontinenz nach totaler Prostatektomie: Der urodynamische Beweis einer anatomischen Hypothese. [Urinary continence after radical prostatectomy: the urodynamic proof of an anatomical hypothesis (author's transl)]
Périodique
Urologia Internationalis
Auteur(s)
Hauri  D., Schauwecker  H., Schmucki  O., Leisinger  H. J., Thachil  J.
ISSN
0042-1138
Statut éditorial
Publié
Date de publication
1976
Peer-reviewed
Oui
Volume
31
Numéro
3
Pages
145-64
Notes
English Abstract
Journal Article
Résumé
Prostatic carcinoma can be cured by a radical operation. In radical prostatectomy the whole so-called internal sphincter is removed. It is generally accepted and often proved that the external sphincter which is mostly somatically innervated cannot resume the funciton of continence. The postoperative urinary incontinence after radical prostatectomy is frequent and therefore the radical prostatectomy is not performed in many places. The problem of postoperative continence as well as incontinence after enucleation of the adenoma will be briefly discussed. In 1966, HUTCH described the so-called 'baseplate'. It is a bundle of smooth muscle fibers, circulary arranged around the bladder neck, which are also responsible for passive continence. He proposed that a certain sphincter function can be achieved by a tubular anastomosis of this anatomical substratum with the distal urethral stump. We were able to prove this anatomical hypothesis urodynamically. A specially constructed double-lumen perfusion catheter enabled us to register the so-called functional urethra profile and simultaneously register a new sphincter pressure wave in the transformed 'baseplate' which was responsible for the continence. We could observe this new sphincter region in all continent patients after radical prostatectomy whereas in the incontinent patients it was absent. Since 1972 we have employed the procedure proposed by HUTCH and have performed 20 radical prostatectomies. All these patients have been postoperatively completely continent. We are of the opinion that undue restraint concerning radical prostatectomy is no more justified.
Mots-clé
Humans Male Muscle, Smooth/physiopathology Postoperative Complications/physiopathology Prostatectomy/methods Prostatic Neoplasms/*surgery Urethra/physiopathology Urinary Incontinence/etiology/physiopathology/*prevention & control
Pubmed
Web of science
Création de la notice
21/01/2008 17:11
Dernière modification de la notice
20/08/2019 14:04
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