title: Extended outcomes in the treatment of male stress urinary incontinence with a transobturator sling.
abstract: OBJECTIVE
  To review extended patient outcomes after male transobturator sling placement for stress urinary incontinence.
  
  
  METHODS
  A retrospective review of a prospectively maintained database for patients with at least 12 months of postoperative follow-up after AdVance male sling placement was performed. Success was defined as a dry safety pad or less (cured) or >50% improvement in pads used per day and patient satisfaction (improved). Patients requiring repeat continence procedures were considered failures.
  
  
  RESULTS
  We reviewed data from 102 patients with a minimum of 12 months of follow-up (mean ± standard deviation 36.2 ± 16.5 months). The mean age at surgery was 66.1 years, and 86.4% had previously undergone a prostatectomy. At 12 months, 24 months, and final follow-up, success rates were 74%, 63%, and 62%, respectively. Although cure rates also declined over time, 40% of patients experienced a durable cure with no complaints of wet pads at final follow-up. Complications were minimal and similar with previous reports. Multivariate Cox regression analysis revealed detrusor overactivity and an elevated detrusor pressure and peak flow negatively predicted being cured using sling placement.
  
  
  CONCLUSIONS
  AdVance sling placement continues to represent a viable option in the treatment of male stress incontinence. Although a decrease in efficacy over time was observed, a substantial portion of patients can expect a durable cure.
authors: Department of Urology, Eastern Virginia Medical School, Norfolk, VA.
authors: Jack M
authors: JM
authors: Zuckerman
authors: Department of Urology, Eastern Virginia Medical School, Norfolk, VA.
authors: Brooke
authors: B
authors: Edwards
authors: Department of Urology, Eastern Virginia Medical School, Norfolk, VA.
authors: Katherine
authors: K
authors: Henderson
authors: Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA.
authors: Hind A
authors: HA
authors: Beydoun
authors: Department of Urology, Eastern Virginia Medical School, Norfolk, VA. Electronic address: kmccam@aol.com.
authors: Kurt A
authors: KA
authors: McCammon
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D011184:Postoperative Period; D016016:Proportional Hazards Models; D011468:Prostatectomy / Q000379:methods; D012044:Regression Analysis; D012189:Retrospective Studies; D053825:Suburethral Slings; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics