OBJECTIVE: To evaluate the outcome of patients treated with a salvage AdVance male sling after a failed primary transobturator sling placement.
METHODS: Retrospective review of patients treated at our center with a primary and subsequent salvage AdVance sling. Success was defined as a dry safety pad or no pads (cured), or >50% improvement in pads used per day and patient satisfaction (improved). Early primary sling failures (< 6 months) were compared with late (≥6 months) failures with regard to continence outcomes.
RESULTS: We identified 18 patients who underwent a salvage AdVance sling placement at our institution. Overall success was 72% at 6 months postoperatively and 56% at a mean follow-up of 17.5 months, including 50% and 39% of patients who were dry at those same time periods. Patients failing late after their primary sling (n = 8) enjoyed improved outcomes with salvage sling placement compared with patients who failed early (n = 10) after the primary sling. At 6 months, more patients in the late primary failure group were cured (75% vs 30%; P = .031). These improved cure rates remained significant through final follow-up with cure rates of 63% and 20%, respectively (P = .041).
CONCLUSION: Salvage AdVance male sling is a viable treatment option after a failed primary sling procedure, especially in patients who demonstrated a prolonged efficacy period before primary sling failure.
Written by:
Martinez EJ, Zuckerman JM, Henderson K, Edwards B, McCammon K. Are you the author?
Department of Urology, Eastern Virginia Medical School, Norfolk, VA.
Reference: Urology. 2015 Feb;85(2):478-82.
doi: 10.1016/j.urology.2014.10.016
PubMed Abstract
PMID: 25559726