title: Update on 2-year outcomes of the TOMS™ transobturator male sling for the treatment of male stress urinary incontinence.
abstract: OBJECTIVE
  To update the 2-year outcomes of the TOMS™ transobturator male sling for treating post-prostatectomy urinary incontinence (pRP-UI) in a group of patients previously evaluated at 1 year.
  
  
  METHODS
  We prospectively followed 40 patients with pRP-UI before and 6, 12, and 24 months after implantation of the TOMS™ transobturator male 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 or only one security pad. We also report on any other surgical procedures for treating persistent incontinence during the follow-up period.
  
  
  RESULTS
  Of 40 patients included in the 1-year follow-up, seven required additional surgical treatment. In the remaining patients (n = 33), significant improvement (P < 0.001) compared to baseline was seen, and a subsequent tendency (non-significant) toward impairment was noted throughout the three postoperative follow-ups for the ICIQ (14.4 ± 4.4 [baseline], 7.6 ± 5.7 [6 months], 8.1 ± 5.6 [12 months], 8.9 ± 5.5 [24 months]), USP-stress urinary (6.7 ± 2.2, 2.8 ± 2.4, 2.8 ± 2.4, 3.2 ± 2.8), ULCA-PCI-urinary bother (10.0 ± 12.5, 66.0 ± 33.0, 64.0 ± 31.5, 62.0 ± 30.7) scores, and pad use (2.5 ± 1.2, 0.7 ± 1.1, 0.8 ± 1.2, 0.9 ± 1.2). Significant impairment in postoperative PGI-I (6.2 ± 0.9, 6.1 ± 0.9, 5.8 ± 1.1, P = 0.028) and USP-overactive bladder symptoms scores (5.4 ± 3.6 [6 months] vs. 6.6 ± 3.7 [24 months], P = 0.046) were noted. A total of 18 (54.5%), 17 (51.5%), and 15 (45.5%) patients wore no postoperative pad, respectively.
  
  
  CONCLUSIONS
  Approximately half of the patients continue to wear no pad 2 years after TOMS™ transobturator male sling implantation. However, a tendency toward impaired continence, possibly associated with overactive bladder symptoms, was noted.
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Henri Mondor Teaching Hospital-Urology Department and CRCDC, Créteil, France.
authors.forename: Rene
authors.initials: R
authors.lastname: Yiou
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Henri Mondor Teaching Hospital-Urology Department and CRCDC, Créteil, France.
authors.forename: Zentia
authors.initials: Z
authors.lastname: Bütow
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Henri Mondor Teaching Hospital-Urology Department and CRCDC, Créteil, France.
authors.forename: Juliette
authors.initials: J
authors.lastname: Parisot
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Henri Mondor Teaching Hospital-Urology Department and CRCDC, Créteil, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Lingombet
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Henri Mondor Teaching Hospital-Urology Department and CRCDC, Créteil, France.
authors.forename: Déborah
authors.initials: D
authors.lastname: Augustin
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Henri Mondor Teaching Hospital-Urology Department and CRCDC, Créteil, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: de la Taille
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Henri Mondor Teaching Hospital-Urology Department and CRCDC, Créteil, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.affiliation: Assistance Publique des Hôpitaux de Paris, Henri Mondor Teaching Hospital-Urology Department and CRCDC, Créteil, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Audureau
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; D012086:Reoperation; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*
keywords: male sling; overactive bladder; radical prostatectomy; urinary incontinence