The male perineal sling: intermediate-term results.
OBJECTIVE
In men with stress urinary incontinence (SUI) due to sphincteric incompetence, surgical options include periurethral injection of bulking agents, implantation of an artificial urinary sphincter (AUS), and sling surgery. Short-term results of the male sling have generally been favorable. We report the intermediate-term results of the bone-anchored male perineal sling with a median of 4 years and minimum of 2 years follow-up.


METHODS
From March 2000 to April 2003, 48 patients (average age = 68 years) underwent male sling surgery. Patients were evaluated pre-operatively and post-operatively via history, physical examination, pad score, and administration of the incontinence section of the UCLA/RAND prostate cancer index (PCI).


RESULTS
Pre-operatively all patients rated their incontinence as severe, and used >or=3 pads daily. Median follow-up was 48 months (range = 24-60). Average pad usage decreased from 4.6 +/- 2.1 pads per day to 1.0 +/- 1.7 pads per day (P < 0.01). Median UCLA PCI incontinence score increased from 63-343 (P < 0.01). Overall, 31/48 patient (65%) were cured of their leakage (no problem, no pads), 7/48 (15%) were much improved (small problem, 1 pad), 3/48 (6%) were mildly improved (moderate problem, 2 pads daily), and 7/48 (15%) failed (big problem, >or=3 pads).


CONCLUSIONS
Intermediate-term results for the male sling demonstrate a success rate comparable to that of the AUS (80% <or= 1 pad daily). This technique has established a very low morbidity, and is a reliable alternative to AUS surgery for the treatment of male SUI.
Comiter
Craig V
CV
Section of Urology, Department of Surgery, University of Arizona, Arizona 85724, USA. ccomiter@u.arizona.edu
D000368:Aged; D001863:Bone Screws; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010502:Perineum; D011183:Postoperative Complications / Q000601:surgery*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery; D013526:Surgical Mesh; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures