title: [Salvage therapy with artificial urinary sphincter after Advance™ male sling failure for post-prostatectomy incontinence: a first clinical experience].
abstract: OBJECTIVE
  To assess the clinical outcome following artificial urinary sphincter (AUS) implantation after failure of Advance™ sub-urethral male sling for post-prostatectomy incontinence (PPI).
  
  
  METHODS
  A prospective evaluation was conducted about consecutive patients who received an AUS after failure of Advance™ therapy in one tertiary reference center. Evaluation included medical history, pad use and operative data (duration, cuff size, technical difficulties). Follow-up was scheduled at 1, 6, 12 months and yearly thereafter. Clinical outcome was evaluated by pad use, patient global impression of improvement (PGI-I) scale and assessment of side effects. Cure was defined as no pad usage.
  
  
  RESULTS
  Twelve patients were included in this evaluation. Median follow-up was 20 months (12-43). No patient was lost to follow-up. Four patients had a history of radiation therapy and all patients had mild or moderate PPI with previous failed Advance™ surgery. Median (range) operative time was 47 minutes (40-60). No technical problem occurred during AUS implantation. Hospital stay duration and catheterization duration were respectively 2 days and 24 hours in all but one case. At last follow-up, 10/12 patients (83%) were cured and fully satisfied. Two were improved, wearing only one pad per day. Postoperative complications were noted in two cases (17%) (one case of cutaneous erosion and one case of superficial iliac wound infection).
  
  
  CONCLUSIONS
  AUS implantation is feasible in patients who have undergone Advance™ male sling implantation. Mid-term results of this procedure are comparable to those obtained after first line AUS implantation.
authors.affiliation: Service d'urologie, université Pierre-et-Marie-Curie Paris 6, hôpital Tenon, groupe hospitalo-universitaire Est, AP-HP, 4, rue de la Chine, 75970 Paris cedex 20, France.
authors.forename: A
authors.initials: A
authors.lastname: Abdou
authors.forename: J-N
authors.initials: JN
authors.lastname: Cornu
authors.forename: P
authors.initials: P
authors.lastname: Sèbe
authors.forename: C
authors.initials: C
authors.lastname: Ciofu
authors.forename: L
authors.initials: L
authors.lastname: Peyrat
authors.forename: O
authors.initials: O
authors.lastname: Cussenot
authors.forename: F
authors.initials: F
authors.lastname: Haab
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D016879:Salvage Therapy; D053825:Suburethral Slings / Q000009:adverse effects*; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*; D016741:Urinary Sphincter, Artificial