OBJECTIVE: To review extended patient outcomes after male transobturator sling placement for stress urinary incontinence.
METHODS: A retrospective review of a prospectively maintained database for patients with at least 12 months of postoperative follow-up after AdVance male sling placement was performed. Success was defined as a dry safety pad or less (cured) or >50% improvement in pads used per day and patient satisfaction (improved). Patients requiring repeat continence procedures were considered failures.
RESULTS: We reviewed data from 102 patients with a minimum of 12 months of follow-up (mean ± standard deviation 36.2 ± 16.5 months). The mean age at surgery was 66.1 years, and 86.4% had previously undergone a prostatectomy. At 12 months, 24 months, and final follow-up, success rates were 74%, 63%, and 62%, respectively. Although cure rates also declined over time, 40% of patients experienced a durable cure with no complaints of wet pads at final follow-up. Complications were minimal and similar with previous reports. Multivariate Cox regression analysis revealed detrusor overactivity and an elevated detrusor pressure and peak flow negatively predicted being cured using sling placement.
CONCLUSION: AdVance sling placement continues to represent a viable option in the treatment of male stress incontinence. Although a decrease in efficacy over time was observed, a substantial portion of patients can expect a durable cure.
Written by:
Zuckerman JM, Edwards B, Henderson K, Beydoun HA, McCammon KA. Are you the author?
Department of Urology, Eastern Virginia Medical School, Norfolk, VA; Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA.
Reference: Urology. 2014 Feb 5. pii: S0090-4295(13)01517-3.
doi: 10.1016/j.urology.2013.10.065
PubMed Abstract
PMID: 24507897
UroToday.com Stress Urinary Incontinence Section
