Male urinary incontinence: a new surgical treatment
Three main advantagesIn comparison with the artificial sphincter, the mesh implant allows spontaneous micturition, there is no mechanical action required by the patient to open and close the urethra. "That is the biggest advantage, especially as we are often dealing with older individuals who may forget to manipulate the system due to their old age". Small disadvantagesThere are few disadvantages to the TOM-Sling, considers the urologist. There are only three and they are relatively rare. "There can be problems of retention: not being able to urinate in the beginning or not being able to urinate for several days or urination may be difficult. For about one patient in six, it will be necessary to reinsert a catheter: instead of removing this after 2 days, we remove it after 8 days. We also encountered a 1 to 2% infection rate at the site of the intervention and sometimes perineal pain (with some numbness), which most often disappears after a few days or weeks. There can be more severe pain, especially in patients that have undergone radiation therapy because the tissues are harder and it is necessary to pull harder etc.” Pain is a common factor to all surgery in this area I believe. With the artificial sphincter, there is not the same level of pain because in turn, there is not the same level of compression. In this case the device opens and closes the urethra without compressing the structures containing blood vessels and nerves". Word of mouthIn Belgium, 300 to 450 patients could benefit from this technique every year. "Our aim is not to carry out 1000 operations per year; we want our system to become viewed as something extremely interesting and positive for the patient. That is our main objective. Following on from this, we would like our technique to be developed elsewhere. We have to act in such a way that urologists show an interest in the technique and that they come to us to receive suitable training. We are a university and we want to train doctors and heal patients. To this end, the Swiss experience is interesting because it has been carried out with other doctors who were delighted with its performance. People are coming from all over to be treated and the trend is increasing. We are therefore confident with regard to the quality of our device", concludes Jean de Leval.
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