Pressure assessment in intercavernous embedding of bulboperineal urethra for treatment of urinary incontinence after prostatic operation

Aim: To put forward criteria for the pressure assessment in the operation o f intercavernous embedding of bulboperineal urethra for the treatment of ur inary incontinence after prostatic operation. Methods: A F14 urethral cathe ter is inserted during the operation and upon suturing the corpora cavernos a centrally, the catheter is slowly pushed in and pulled out in order that the operator feels a certain degree of close-fit resistance. The degree of tightness of the stitches, which regulate the compression pressure, is adju sted in accordance with this close-fit sensation. To further ascertain the adequacy of the force of compression, the bladder is filled with 300 ml phy siological saline and observe the appropriateness (size and continuity) of the outflow stream when the lower abdomen is depressed with a pressure of 8 0 - 90 cm. H2O. The operation was given to six patients suffered from urina ry incontinence for 20 or more months after prostatic operation. Results: F ive cases achieved complete recovery, while the therapeutic effect of the 6 th one was not satisfactory. A second stage operation was carried out 3 mon ths later with the addition of one more stitch both proximally and distally to reinforce the compression force. The condition was improved dramaticall y. The follow-up period averaged 3.5 years. Conclusion: The adequacy of the compression pressure exerted by the juxtaposed corpora cavernosa is the ke y point determining the outcome of the operation. The measures for assessin g the compression pressure suggested by the authors are helpful in obtainin g the good results of the present paper (6/6 success) as compared with 25/3 4 success in the previous report.