Clinical
Male Stress Urinary Incontinence (Post Prostatectomy Incontinence)
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Abstract Centre
Victo is an artificial urinary sphincter, consisting of three parts which are pre-connected. The video describes the implantation technique of this device.
VICTO is a single unit preconnected adjustable device with an occluding cuff (OC), a pressure regulating balloon (PRB) and a self-sealing port for pressure adjustment. This video shows initial preparation and measurement of the urethra as according to the established technique. After measuring the urethra, the device is prepared and filled with 13 ml of saline or isotonic contrast. Afterward the pressure regulating balloon is placed intra-peritoneally, because in case of an extra-peritoneal implantation the fibrotic capsula creation around the balloon could change the overall pressure in the system. A camera bag is used for the passage of the cuff through the subcutaneous channel to prevent a fraction between the device and the surrounding tissue. The cuff was then placed around the urethra and closed using a atraumatic forcep and a Mosquito clamp. The perineal wound is closed using absorbable 3.0 sutures. Finally, the pump was place in the scrotum and the abdominal incision was closed using skin staplers.
We have implanted over 100 devices so far and there were no intra-operative complications. The activation of the device was usually performed after 4-6 weeks by adding 5ml of saline to the system. Activation and adjustments can be done easily by puncturing the integrated pump-port.
The device provides adjustability in regulating pressure in situ. The implantation and filling procedure are shown in this video. Adjusting the system pressure to the lowest level providing continence may reduce the long-term rate of complications.