[Experience with the Kaufman prosthesis in the treatment of postoperative urinary incontinence in the male].
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Abstract
22 patients had urinary incontinence plastic surgery according to Kaufman. Good and satisfactory results (n = 14) are to be expected only in cases of genuine stress incontinence following iatrogenic lesion of the sphincteral mechanism. Preoperative urodynamic clarification is obligatory for excluding neurogenic micturition disorders, detrusor-sphincter dyssynergia and bladder instability. Because of the clearly increased complication rate in prostatic cancer, Kaufman-incontinence-plastic surgery should only be carried out when over a period of 12 months tumour progression is not to be expected or when radical prostatectomy was done. Complications with necessary prosthesis removal (n = 9) occurred without exception within 8 weeks after surgery. Among them were two cases of decubital necrosis of the urethra, five cases of secondary wound healing and one case of detrusor-sphincter dyssynergia. General contraindications are: chronically recurrent urinary tract infection, urethral stricture, urethral diverticulum, vesico-urethral reflux with dilated upper urinary tract and the so-called "scarred-rigid urethra".