Intermediate-term results, up to 4 years, of a bone-anchored male perineal sling for treating male stress urinary incontinence after prostate surgery.
OBJECTIVE
To examine the intermediate-term outcome (up to 4 years) of a bone-anchored perineal sling (InVance(TM), American Medical Systems, Minnetonka, MN, USA) in men with stress urinary incontinence (SUI) after prostate surgery.


METHODS
In all, 62 men with SUI were implanted with the InVance sling. SUI was diagnosed after radical prostatectomy in 58 patients and after benign prostatic hyperplasia (BPH) prostatectomy in four patients. Implantation of the InVance bone-anchored bulbourethral sling was conducted primarily under spinal anaesthesia. Patients were considered cured, if they stopped wearing continence pads and improved if the daily number of pads used decreased by at least half. The Incontinence Quality of Life questionnaire and a simple verbal question about patient satisfaction with the surgery were also used and complications were measured.


RESULTS
In all, 40 patients (65%) were cured and 14 (23%) were improved after a mean follow-up of 28 months. The UI cure rates at 3 and 4 years follow-up were 70% and 66%, respectively. The most common side-effect was transient scrotal or perineal pain or numbness, which affected 12 patients (19%). There was a prolonged postvoid residual urine volume of >100 mL in six patients (10%), which resolved within 2 weeks of indwelling catheterization. Explantation of the sling was required in two cases (3%) because of infection. In one patient (2%), revision was required for bone-anchor dislodgement.


CONCLUSIONS
The InVance sling offers good intermediate-term cure and improvement rates for SUI after prostatectomy. The procedure has an acceptably low rate of minor complications, and should be considered for treating men with less severe forms (< or =5 pads per day) of SUI.
Guimarães
Miguel
M
Department of Urology, Hospital São João, Portugal. mgdeep@gmail.com
Oliveira
Rui
R
Pinto
Rui
R
Soares
Alfredo
A
Maia
Eurico
E
Botelho
Francisco
F
Sousa
Teixeira
T
Pina
Francisco
F
Dinis
Paulo
P
Cruz
Francisco
F
D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010502:Perineum; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012307:Risk Factors; D012720:Severity of Illness Index; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D053441:Suture Anchors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000628:therapy*; D016741:Urinary Sphincter, Artificial