Dr Jo Schoeman
Urological Surgeon

        

Macroplastique Peri-urethral Injections

Product Summary: AMA rates

Periurethral bulking for type 3 incontinence, Lead-pipe urethra (ISD)

Item Number: 37339, 105

Why is it done?

  • Where Intrinsic Sphincter Deficiency has been proved after failed previous sling.

Pre-requirements

  • An informed consent is required from the patient and a pre-admission clinic will be arranged.
  • Patients may not eat or drink from midnight the previous evening.
  • Patients are to refrain from smoking before the procedure.
  • Patients allergic to IODINE / CHLORHEXIDINE should clearly state this at the pre-admission clinic as well as to theatre staff and Dr Schoeman.
  • Any anti-coagulants such as Warfarin or Aspirin must be stopped 7 days prior to surgery. This may be replaced by once daily Clexane injections.
  • Usually a day-procedure.

How is it done?

  • This procedure is done under a spinal / general anaesthetic, as decided by the anaesthetist.
  • The legs will be elevated into the lithotomy position.
  • This procedure is done cystoscopically.
  • 3 peri-urethral injections are made with injection of Macroplastique until the urethral lumen closes.
  • Your urine output will be measured each time you urinate and the residual will be measured. (Patients will be required to do this up to 3 times.)
  • If the residual amount of urine is more than 1/3 of the total bladder capacity, the patient may have to self catheterise, until the residual volume is acceptable.
  • Prophylactic antibiotics will be given to prevent infection.

What to expect after the procedure?

  • Any anaesthetic has its risks and the anaesthetist will explain all such risks.
  • Complications: hemorrhaging, and urine retention.
  • Patients will have no catheter when they wake up.
  • If you cannot urinate after 2-3 attempts, an in-out catheter may be inserted to empty your bladder.
  • You may be required to self catheterize for a week or two.
  • NB! Each person is unique and for this reason symptoms may vary!

What next?

  • Patients will have a trial of void without catheter the next day.
  • Patients will be discharged as soon as they can completely empty the bladder.
  • Patients may be required to self catheterize for a week or two.
  • Patients may initially suffer from urge incontinence but this will improve within the next 6 weeks.
  • Allow 6 weeks for symptoms to stabilise.
  • You may not experience a full return of continence and the effects may worsen with time.
  • More than 1-2 treatments may provide the desired effects.
  • There may be some blood in the urine. This can be remedied by drinking plenty of fluids until it clears.
  • On discharge a prescription may be issued for patients to collect.
  • Patients are to schedule a follow-up appointment in 6 weeks. 
  • Please direct all queries to Dr Schoeman’s rooms.
  • PLEASE CONTACT THE HOPSITAL DIRECT WITH ANY POST-OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL IMMEDIATELY SHOULD THERE BE ANY SIGNS OF SEPSIS.
  • Macroplastique Peri-Urethral Injections Macroplastique Peri-Urethral Injections (394 KB)