Introduction: There are many well-known complications after gluteal augmentation surgery, such as: seroma, hematoma, capsular contracture, retraction, wound dehiscence etc., but there are some due to nervous damage (especially submuscular pockets with large implants) insufficiently recognized. The aim of this case report is to highlight a rare complication (urinary retention) after gluteal augmentation surgery with use of solid silicone implants in case of 41-year-old female. Woman aged 41 with a buttock augmentation with silicone implant (submuscular pocket, 300cc) performed 2 months before at plastic surgery service in Madrid, was admitted in our service, the Clinic of Urology from Tg. Mures, with permanent bladder catheter inserted for urinary retention.
Outcome: At the admission, two months after the surgery the clinical examination revealed a permeable urinary catheter with clear urine and a fistulisated wound infection localized in the superior 1/3 of the incision in the intergluteal sulcus. Neither neurological or gynecological examination identified any pathology. After the removal of the catheter, next day the abdominal ultrasonography showed a distended bladder, with a postvoid residual urine volume of 320 ml. Urodynamic investigations (uroflowmetry, pressure flow studies) revealed a reduced Qmax. 7,6 ml/sec, underactive detrusor with a reduced BCI value of 60 (bladder contractility index), requiring self-intermittent catheterization, associated with alpha-blockers.
Conclusions: Buttock implantation is a frequently used plastic surgery procedure with rather high rate of complications, some of them not well identified, unknown such as detrusor underactivity leading to urinary retention.
Tag Archives: uroflowmetry
The Role of Urodynamic Investigations in Management of Stress Urinary Incontinence
Objective: The aim of this study is to establish the importance of urodynamic investigations in women diagnosed with stress urinary incontinence (SUI) who have indication of surgical treatment.
Methods: We performed a retrospective study over a period of 3 years (January 2012-December 2014) in Clinic of Urology from Tirgu Mures. The inclusion criteria were: female patients diagnosed with SUI having indication of surgical treatment and the existence of urodynamic investigations (uroflowmetry and pressure-flow study). We evaluated 118 patients with SUI. From this patients, 24 cases (20.3%) accomplished the criteria from above.
Results: We included in this study 24 patients aged 64.25+/-8.25 (standard deviation). Pressure-flow study revealed an impaired detrusor contraction in 13 cases. Statistical anaysis pouved a relation between existence of post void residual urine (PVR) and underactive detrusor (UD) (p=0.01). There is no correlation between maximum flow rate (Qmax) and UD, r=0.18 (CI= -0.2-0.5), p=0.3 and between normal value of Qmax and normal detrusor pressure (Pdet), r= 0,28(CI=-0.6-0.8), p=0.58. Also there is no relation between a low Qmax and UD, p=0,5. There is a statistical relation between increased abdominal pressure (Pabd) and UD, p=0.02.
Conclusions: Uroflowmetry has the role to guide us concerning the micturition process Pressure-flow study is indicated in management of SUI, in selected cases, in patients with voiding symptomatology, the suspicion of a detrusor contractility dysfunction, abnormal uroflowmetry results, existence of PVR, in prediction of the surgical treatment outcome or if we think that the findings can change the choice of treatment.