PATIENTS AND METHODS: In 20 patients three-dimensional transrectal ultrasound was preformed before and after intraurethral Macroplastique (Uroplasty, Belgium) injections. 1 male patient suffered from posttraumatic urinary stress incontinence. 18 Patients presented with postoperative stress incontinence after transurethral resection (2) or radical prostatectomy (16) of the prostate. 1 female patient had urinary stress incontinence after cystectomy and orthotopic reconstruction of the lower urnary tract. The ultrasound equipment used for this study consisted of a COMBISON 330 and a VOLUSON 3D multiplanar endorectal transducer (7.5 MHz) produced by KRETZTECHNIK (Austria).
RESULTS: In the patient with posttraumatic incontinence the rhabdosphincter could not be identified. In all other patients the rhabdosphincter could be clearly seen. Defects or atrophies of the rhabdosphincter were present in all patients. After Macroplastique injection the depots presented as hyperechogenic structures. The correlation between the depots and the rhabdosphincter could be demonstrated very well; especially the coronal plane provided exact information of the position of the Macroplastique depots. Of the 20 patients treated with Macroplastique, 4 patients were fully continent and 14 patients showed marked improvement of the symptoms so that no further treatment was necessary. In 2 patients no improvement was achieved.
CONCLUSIONS: Three-dimensional transrectal ultrasound is capable of providing sonographic pictures of the rhabdosphincter and Macroplastique depots in three planes simultaneously (sagittal, horizontal and coronal), which so far has not been possible with conventional techniques.
Source: Original abstract