title: Results of the AdVance transobturator male sling after radical prostatectomy and adjuvant radiotherapy.
abstract: OBJECTIVE
  To prospectively evaluate the efficacy of the functional AdVance transobturator sling for the treatment of male stress urinary incontinence (SUI) in patients after radical prostatectomy and additional adjuvant radiotherapy.
  
  
  METHODS
  Between February 2007 and November 2008, 24 patients with postprostatectomy SUI (ICS grade 2-4) and additional adjuvant radiotherapy were treated consecutively with the AdVance sling. Preoperatively, intensive workup, including urodynamic assessment and flexible urethroscopy, was performed. Physical examinations (pad test, uroflowmetry, ultrasound) and questionnaires (I-QOL score, ICIQ-UI-SF score) were performed during baseline and during follow-up. Cure rate was defined as no pad use or one dry pad, and improved rate as 1-2 pads or reduction of pads by ≥50%.
  
  
  RESULTS
  After a median follow-up of 18.0 months (range 12-33 months, mean 18.8 months), the success rate was 50%. Daily pad use and pad weight in the 1-hour pad test decreased significantly. Patients with ICS grade 2 SUI exhibited a trend for a better success rate in comparison with patients with grade 3 and 4 SUI. Results were durable over time. Postoperatively, 16.7% of the patients exhibited transient acute urinary retention which resolved without further treatment after a maximum of 6 weeks. 1 sling had to be removed because of initial misplacement.
  
  
  CONCLUSIONS
  In selected patients after adjuvant radiotherapy, the AdVance sling achieved a success rate of 50% and results were stable in a median follow-up of 18 months. Complication rates were low and comparable to complication rates for patients without additional radiotherapy.
authors.affiliation: Department of Urology, Ludwig-Maximilian-University, Munich, Germany. Ricarda.Bauer@med.uni-muenchen.de
authors.forename: Ricarda M
authors.initials: RM
authors.lastname: Bauer
authors.forename: Irina
authors.initials: I
authors.lastname: Soljanik
authors.forename: Claudius
authors.initials: C
authors.lastname: Füllhase
authors.forename: Alexander
authors.initials: A
authors.lastname: Buchner
authors.forename: Florian
authors.initials: F
authors.lastname: May
authors.forename: Christian G
authors.initials: CG
authors.lastname: Stief
authors.forename: Christian
authors.initials: C
authors.lastname: Gozzi
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects; D011474:Prosthesis Design; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000209:etiology* / Q000601:surgery*