[The combined treatment of urinary incontinence after adenomectomy]

Treatment was applied in 55 patients with enuresis after removal of adenoma of the prostate. Nonoperative treatment of 46 patients included therapeutic exercises, drug therapy (anti-inflammatory agents and tonics), and physical methods: transurethral direct electrical stimulation of the vesical sphincters (25 patients), transperineal ultrasonic stimulation (21 patients). After nonoperative treatment enuresis was completely cured in 31 patients. Fifteen patients with poor results were subjected to a second course of treatment: a satisfactory result was produced in another 6 patients, an improvement was recorded in 9 patients. Operative treatment was carried out in 9 patients: 4 of them by A. Puigvert's method (satisfactory result in 1, improvement in 1, poor result in 1, acute ischuria in 1) and 5 by a modified Puigvert's operation the techniques of which consisted in forming 2 rectangular grafts from the tunica albuginea of the cavernous bodies of the penis, suturing the medial grafts to one another above the urethra on the midline, and suturing to their bases the lateral grafts (satisfactory results in 4, improvement in 1). Thus, complex treatment of 55 patients for enuresis consequent upon removal of adenoma of the prostate caused a satisfactory result in 42 (76.4%), an improvement in 11 (20%), and a poor result in 2 (3.6%) patients.