[First experiences with the incontinence operation Kaufman III (implantation of a silicongel prothesis covered with polyurethanfoam) (author's transl)]

Abstract

For operative treatment of urinary incontinence after TUR of the prostate, radical prostatectomy and meningocele operation the silicongel prothesis described by Kaufman was implanted. By compression of the bulbus urethrae a sealing effect was achieved. The pressure of the detrusor opens the urethra enough to enable urination. Seven patients were operated. The results directly after the operations were: three very good, two good and two bad. We achieved very good results by implantation of the prothesis "large" -in the case of the two bad operative results we used the "medium" size prothesis. By filling these protheses with 5 ml liquid they proved to be leaky. One of these was operatively removed and replaced by the size "large". This patient later developed a urethra stricture in the implantation region with overflow bladder after having been continent. By internal urethrotomy this condition was restored; except for minor dripping after miction the patient was continent. The prothesis of a direct postoperative continent patient had to be filled. This led to and infection with the development of fistula. The prothesis had to be removed. A further patient who sat on a hard object developed a lesion of the prothesis with resulting incontinence. At least six months after the operations four patients remained continent and three incontinent.