Mid-term results for the retroluminar transobturator sling suspension for stress urinary incontinence after prostatectomy.
OBJECTIVE
• To evaluate prospectively the efficacy of the retroluminar transobturator male sling (AdVance® sling) for the functional treatment of stress urinary incontinence (SUI) after prostatectomy.


METHODS
• A total of 137 patients with grade II-IV SUI, resulting from radical prostatectomy, were treated with the AdVance® sling in a prospective clinical study. In all, 11 patients were lost to follow-up. A total of 17 patients (13.5%) had additional adjuvant radiotherapy before sling implantation. • Before and after sling implantation, a standardized 1-h pad test was performed and post-void residual urine, uroflowmetry, quality-of-life scores and the International Index of Erectile Function (IIEF-5) were assessed. • When calculating the cure and improvement rates, 'cure' was defined as no pad use or one dry prophylactic pad; and 'improved' was defined as 1-2 pads or reduction of pads ≥ 50%.


RESULTS
• After a median (range) follow-up of 27 (20-37) months, and a mean follow-up of 27.2 months, the success rate was 75.4% with 51.6%'cured' and 23.8%'improved'. • Overall daily pad use, urine loss in the 1-h pad test and quality-of-life scores improved significantly after sling implantation. • Compared with 1-year follow-up data, no worsening over time was noticed and no additional complications were seen.


CONCLUSIONS
• With a mid-term follow-up, the retroluminar transobturator male sling is an effective, safe and attractive treatment option for SUI after radical prostatectomy. Results are stable over time.
Bauer
Ricarda M
RM
Department of Urology, Ludwig-Maximilian-University, Munich, Germany. Ricarda.Bauer@med.uni-muenchen.de
Soljanik
Irina
I
Füllhase
Claudius
C
Karl
Alexander
A
Becker
Armin
A
Stief
Christian G
CG
Gozzi
Christian
C
D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects*; D011788:Quality of Life; D053825:Suburethral Slings / Q000009:adverse effects; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*