title: Evaluation of urinary symptoms in patients with post-prostatectomy urinary incontinence treated with the male sling TOMS.
abstract: OBJECTIVE
  To evaluate stress urinary incontinence (SUI), overactive bladder (OAB), and obstructive symptoms in patients with post-radical prostatectomy urinary incontinence (pRP-UI) treated with the bulbar compressive sling TOMS, and investigate the effect of each urinary symptom on urinary bother.
  
  
  METHODS
  We prospectively followed 40 patients with pRP-UI before, and 6 and 12 months (T6 and T12, respectively) after implantation of the TOMS sling. Urinary symptoms were evaluated using the following questionnaires: USP, ICIQ, UCLA-PCI (urinary bother domain), PGI-I, and daily pad use. Success was defined as patients wearing no pads or using one security pad.
  
  
  RESULTS
  Significant improvement of mean USP-SUI (6.97/9, 3.35, 3.02, P < 0.001) and USP-OAB domains (8.1/21, 5.74, 5.71, P < 0.001), ICIQ (15.15/21, 8.17/21, 8.35/21, P < 0.01), urinary bother (92.5/100, 42.5, 41.87, P < 0.001), and pad number (2.78, 1.01, 1.03, P < 0.001) were noted between baseline, T6, and T12. At baseline, 32 (80%) patients reported urge incontinence. Urinary bother strongly correlated with UPS-SUI but not with UPS-OAB score. At T12, 22 (55%) patients with pad use were considered cured, and 13 (32.5%) patients reported a greatly improved urinary tract condition (PGI-I). Improvement of USP-SUI and USP-OAB scores correlated with improvement of ICIQ and PGI scores. The USP-obstructive domain remained unchanged.
  
  
  CONCLUSIONS
  The TOMS sling improves SUI and OAB symptoms without generating obstructive symptoms. OAB symptoms including urge incontinence reported by most patients were not a major concern at baseline; however, improvement of these symptoms was associated with improvement of continence and PGI-I scores.
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Urology Department and CRCDC, Henri Mondor Teaching Hospital, Créteil, France.
authors.forename: René
authors.initials: R
authors.lastname: Yiou
authors.forename: Catherine-Marie
authors.initials: CM
authors.lastname: Loche
authors.forename: Odile
authors.initials: O
authors.lastname: Lingombet
authors.forename: Claude
authors.initials: C
authors.lastname: Abbou
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.forename: Alexandre
authors.initials: A
authors.lastname: de la Taille
authors.forename: Etienne
authors.initials: E
authors.lastname: Audureau
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D011788:Quality of Life; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000209:etiology; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*
keywords: male sling; overactive bladder; radical prostatectomy; urinary incontinence