Transurethral resection of the prostate (TURP) is rarely complicated with stress incontinence due to isolated external sphincter injury. This has been treated with either teflon paste or collagen. Teflon paste is migratory and associated with progressive fibrosis. Injectable collagen may not be effective in the longterm due to autodigestion. Macroplastique (TH) consists of textured silicone macroparticles (polydimethyl siloxane) that are non-migratory when injected submucosally and heal in a thin fibrin capsule without progressive fibrosis. Over the last 24 months 21 male stress incontinent patients were treated with transurethral submucosal injections of Macroplastique to the external sphincter defect. 31 injections were performed on 21 patients. 9 of 21 patients are dry (43%), 4 patients all improved (19%) and 8 patients remain the same (38%). Injectable silicone macroparticles are a simple and safe alternative to teflon paste for post TURP incontinence in the elderly male who is unable to manipulate the artificial urinary sphincter. The implants are a safe alternative to the implantable sphincter device in the younger patient.
Source: Original Abstract