title: The AdVance male sling as a minimally invasive treatment for intrinsic sphincter deficiency in patients with neurogenic bladder sphincter dysfunction: a pilot study.
abstract: OBJECTIVE
  The aim of the study was to evaluate feasibility, efficacy, and safety of the AdVance male sling in neuropathic male patients with intrinsic sphincter deficiency.
  
  
  METHODS
  We evaluated 20 consecutive male neuropathic patients (12 menigomyelocele and 8 lower spinal cord injured), age 23 ± 13 years (range 6-52 years) with urodynamically proven sphincter deficiency and stress urinary incontinence. In all patients an AdVance male sling was implanted from June 2007 to September 2009. Patients were evaluated with the number of pads per day (PPD), visual analogue scale (VAS) for continence and the International Consultation on Incontinence-Short Form (ICIQ-SF). Cure was defined as a 10 on VAS or using no pads for urinary leakage, improvement as >5 and failure as ≤5.
  
  
  RESULTS
  Positive effect in 13 of 20 patients (65%) at 1-year follow-up: 8 patients were cured, 5 improved, and 7 failed. VAS score increased from baseline 2.6 (SD 2.0) to 7.2 (SD 3.5) at 12 months (P < 0.001). ICIQ-SF decreased from 14 (SD 4.2) to 4 (SD 4.1) (P < 0.001). Friedman and Wilcoxon tests revealed at 1, 3, 6, 9, and 12 months significant improvement compared to baseline (P = 0.008).
  
  
  CONCLUSIONS
  Implantation of the AdVance male sling is feasible in both adult and pediatric patients. A promising cure/improvement rate was achieved as well as a low complication rate.
authors: Department of Urology, Ghent University Hospital, Ghent, Belgium. luitzenalbert.groen@uzgent.be
authors: Luitzen-Albert
authors: LA
authors: Groen
authors: Anne-Françoise
authors: AF
authors: Spinoit
authors: Piet
authors: P
authors: Hoebeke
authors: Erik
authors: E
authors: Van Laecke
authors: Bart
authors: B
authors: De Troyer
authors: Karel
authors: K
authors: Everaert
mesh_terms: D000328:Adult; D002648:Child; D005240:Feasibility Studies; D006801:Humans; D016496:Incontinence Pads; D008297:Male; D008588:Meningocele / Q000150:complications; D008875:Middle Aged; D010865:Pilot Projects; D020127:Recovery of Function; D013119:Spinal Cord Injuries / Q000150:complications; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D055815:Young Adult