title: The AdVance transobturator male sling for postprostatectomy incontinence: clinical results of a prospective evaluation after a minimum follow-up of 6 months.
abstract: BACKGROUND
  Transobturator male slings have been proposed to manage stress urinary incontinence (SUI) after prostatic surgery, but data are still lacking.
  
  
  OBJECTIVE
  To determine the safety and prospectively evaluate the clinical outcome after management of SUI after prostatic surgery by placement of a transobturator male sling.
  
  
  METHODS
  We conducted a prospective evaluation on 102 patients treated in a single center between 2007 and 2009 for mild to moderate SUI following prostatic surgery.
  
  
  METHODS
  Placement of a suburethral transobturator sling and clinical follow-up.
  
  
  METHODS
  Patients were evaluated by medical history, preoperative urodynamics, maximum flow rate measurement, 24-h pad test, and daily pad use. During follow-up, data on patients' pad use, complications, and answers to the Patient Global Impression of Improvement (PGI-I) questionnaire were collected. Cure was defined as no pad usage or one pad for security reasons and improvement as reduction of pads≥50%. Median follow-up was 13 mo (range: 6-26).
  
  
  CONCLUSIONS
  Most patients (95%) presented post-radical prostatectomy incontinence (PRPI). Hospital stay was 2 d in 97 cases, and all patients were catheterized for 24h except two (48 h). Of 102 patients, 64 were cured, 18 were improved, and 20 were not improved. According to the PGI-I questionnaire, 85%, 11%, and 4% of patients described a respectively better, unchanged, and worse urinary tract condition, respectively. Previous radiation was associated with higher rate of failure (p=0.039). Neither severe complication nor postoperative urinary obstruction was noted during follow-up.
  
  
  CONCLUSIONS
  Placement of a transobturator sling is a safe and effective procedure, giving durable results after >1 yr of follow-up. Further evaluation and high-quality controlled, randomized studies are needed to assess long-term efficacy and precise indications of this procedure for post-prostatic-surgery SUI management.
authors.affiliation: Department of Urology, Tenon Hospital, Groupe Hospitalo-Universitaire EST, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris VI, Paris, France. jncornu@hotmail.fr
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Cornu
authors.forename: Philippe
authors.initials: P
authors.lastname: Sèbe
authors.forename: Calin
authors.initials: C
authors.lastname: Ciofu
authors.forename: Laurence
authors.initials: L
authors.lastname: Peyrat
authors.forename: Sébastien
authors.initials: S
authors.lastname: Beley
authors.forename: Mohammed
authors.initials: M
authors.lastname: Tligui
authors.forename: Bertrand
authors.initials: B
authors.lastname: Lukacs
authors.forename: Olivier
authors.initials: O
authors.lastname: Traxer
authors.forename: Olivier
authors.initials: O
authors.lastname: Cussenot
authors.forename: Francois
authors.initials: F
authors.lastname: Haab
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D016496:Incontinence Pads; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000601:surgery*; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D053825:Suburethral Slings / Q000009:adverse effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*