title: Objective and quality-of-life outcomes with bone-anchored male bulbourethral sling.
abstract: OBJECTIVE
  To investigate the success rates and quality-of-life outcomes with the male bulbourethral sling using the validated Male Urogenital Distress Inventory (MUDI) and Male Urinary Symptom Impact Questionnaire (MUSIQ). These validated incontinence questionnaires for men have not been reported in the sling population.
  
  
  METHODS
  A total of 31 consecutive patients underwent placement of a male bulbourethral bone-anchoring sling from October 2002 through May 2005. The preoperative information included history and physical examination, pad history, urodynamic findings, and MUDI and MUSIQ results. Postoperatively, the patients were evaluated clinically and completed a MUDI and MUSIQ every 6 months.
  
  
  RESULTS
  Of the 31 patients, 24 completed the questionnaires and follow-up protocol. Of the other 7 patients, 4 underwent sling removal and 3 were lost to follow-up. The average follow-up time was 15 months (range 9 to 21). After surgery, the pad use decreased from a median of 3.7 pads/day (range 1 to 12) to 1.3 pads/day (range 0 to 6). Of the 24 analyzed patients, 18 (75%) were dry or using 1 pad or less per day, and 9 (38%) no longer needed pads. Subjectively, 75% of the patients were satisfied. The mean MUDI and MUSIQ scores decreased from 56.8 and 29.9 preoperatively to 44.8 (P <0.0001) and 14.6 (P = 0.002) after sling placement, respectively. When all 31 patients were included, our clinical success rate of 1 pad/day or less decreased to 58%.
  
  
  CONCLUSIONS
  Of the 24 patients with follow-up data, 75% were satisfied and were clinically cured. A significant improvement was seen after surgery in the MUDI and MUSIQ scores, severity of incontinence, and average pad use. The MUDI and MUSIQ scores paralleled patient satisfaction and clinical success after male bulbourethral sling placement.
authors.affiliation: Department of Urology, University of Iowa, Iowa City, Iowa 52242-1089, USA.
authors.forename: Brian L
authors.initials: BL
authors.lastname: Gallagher
authors.forename: Neil T
authors.initials: NT
authors.lastname: Dwyer
authors.forename: Darlene M
authors.initials: DM
authors.lastname: Gaynor-Krupnick
authors.forename: Jerilyn M
authors.initials: JM
authors.lastname: Latini
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Kreder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects; D011788:Quality of Life; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D053441:Suture Anchors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male