Article

A Medical Silastic Prosthesis for the Control of Urinary Incontinence in the Male

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Abstract

IN 1961, Berry1 reported a new surgical procedure for the control of urinary incontinence, in the male, resulting from an ineffective sphincter mechanism. He created a new “sphincter” in the bulbus urethra by implantation of an acrylic prosthesis between the bulbocavernosus and the bulbus portion of the urethra. The prosthesis saddled the urethra and was fixed in position by four wire sutures located at each corner of the prosthesis, the wires being anchored to the fascia of the ischiocavernosus and the ischial tuberosities. The increase in urethral resistance created in the area of the bulbus urethra near the membranous urethra was sufficient to achieve continence, yet still allow a free-flowing urinary stream during micturition.

We have used a new material and have made minor modifications in the design of the prosthesis used in the Berry operation, and this preliminary report concerns our experience with five male patients treated for urinary incontinence.

Material

The material used for the prosthesis is silicone rubber (Medical Silastic), which has been widely used in recent years for medical implants in the human body. Among its attributes for this purpose are: (1) it causes minimal tissue reaction, (2) it is inexpensive, and (3) it is easy to prepare and to design for implantation.

The prosthesis is fashioned from a rectangular block of Medical Silastic approximately 3 cm. by 2 cm. by 0.75 cm. (Fig. 1A). A saddle effect is then achieved by creating a midline grooved depression on the inner or urethral surface of the prosthesis. . .


 

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