Efficacy of the InVance male sling in men with stress urinary incontinence.
OBJECTIVE
To evaluate the efficacy and safety of the InVance bulbourethral sling in male stress urinary incontinence.


METHODS
Between June 2003 and April 2005, the InVance bulbourethral sling was implanted into 50 patients with urinary incontinence after prostate surgery in 49 cases and pelvic trauma in 1 case. The patients were monitored and evaluated in a prospective manner (continence, tolerance, and satisfaction). The treatment was considered to be successful if the patient stopped wearing any kind of continence pad (patient cured) or only one pad per day (patient improved), with no de novo urinary disorders and without significant postvoid residual urine. Patient satisfaction with the procedure was assessed.


RESULTS
After a median follow-up of 6 mo, 50% of patients were dry, 26% had improved, and 24% suffered treatment failure. The success rates for the patients with severe incontinence and those who had undergone radiation therapy were 50% and 25%, respectively. All patients who were dry or had improved were satisfied and presented no obstructive or irritative de novo urinary disorders. The overall success rate for the 51 procedures conducted was 74.5%. Six cases of transitory acute urine retention and six cases of persistent perineal pain were reported. Explantation was necessary because of suppuration of the sling in three patients and of a de novo irritative urinary disorder in one patient. No cases of pubic osteitis or urethral erosion were reported.


CONCLUSIONS
The InVance bulbourethral sling procedure makes it possible to treat stress urinary incontinence after prostate surgery with satisfactory and lasting short-term results. Severe incontinence and a past history of pelvic radiation therapy seem to be factors contributing to the failure of this procedure.
Fassi-Fehri
Hakim
H
Department of Urology and Transplantation, Edouard Herriot Hospital, Lyon, France. hakim.fassi-fehri@chu-lyon.fr <hakim.fassi-fehri@chu-lyon.fr>
Badet
Lionel
L
Cherass
Arnaud
A
Murat
François-Joseph
FJ
Colombel
Marc
M
Martin
Xavier
X
Gelet
Albert
A
D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods