[Multicenter study of Advance ® suburethral sling for treatment of postoperative urinary incontinence of male].
OBJECTIVE
To estimate in the medium term, the efficiency and morbidity of Advance(®) for the treatment of postoperative urinary incontinence for male, and determine predictive preoperative factors of success or failure.


METHODS
Retrospective multicentric clinical study of patients presenting a postoperative urinary incontinence and treated by Advance(®) suburethral sling. The importance of the preoperative incontinence was classified in three groups: light (pad-test<50 g/day or 1 pad/day), moderated (pad-test between 50 and 100 g/day or 2 or 3 pads/day), severe (pad-test>100 g/day or >3 pads/day). The functional results were classified in 4 categories: continence and improvement, defining the criterion of success and unchanged situation and deteriorated situation defining the criterion of failure.


RESULTS
Sixty-six patients were included from 2008 till 2013. The radical prostatectomy was responsible in 85.5% of the cases. The incontinence was light, moderated and severe for respectively 43.4%, 35.6% and 21% of the patients. After treatment, 39.4% of the patients were continent and 78.9% in situation of success. The rate of success decreased with the severity of the incontinence (respectively 94%, 74% and 56%). For 9 patients, implantation of artificial urinary sphincter was performed without operative difficulties. Complications were urine retention (n=4), hematoma (n=3) and scrotal pains persistent more than one postoperative month (n=11).


CONCLUSIONS
Advance(®) suburethral sling is a technique in which the efficiency decreases with the severity of the incontinence, but which does not seem to prevent from implanting artificial urinary sphincter. Its main problem is the apparition of scrotal pain.
Service d'urologie, CHU de Bordeaux, place Amélie-Raba-Leon, 33000 Bordeaux, France; Service d'urologie, CHU de Pellegrin, place Amélie-Raba-Leon, 33000 Bordeaux, France. Electronic address: laurent.mascle@me.com.
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Mascle
Service d'urologie, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges, France. Electronic address: aurelien.descazeaud@chu-limoges.fr.
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Descazeaud
Service d'urologie, CHU de Bordeaux, place Amélie-Raba-Leon, 33000 Bordeaux, France. Electronic address: gregoire.robert@chu-bordeaux.fr.
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Robert
Service d'urologie, CHU de Bordeaux, place Amélie-Raba-Leon, 33000 Bordeaux, France. Electronic address: jcb31000@hotmail.com.
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Bernhard
Service d'urologie, CHU de Bordeaux, place Amélie-Raba-Leon, 33000 Bordeaux, France. Electronic address: henri.bensadoun@chu-bordeaux.fr.
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Bensadoun
Service d'urologie, CHU de Bordeaux, place Amélie-Raba-Leon, 33000 Bordeaux, France. Electronic address: jean-marie.ferriere@chu-bordeaux.fr.
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Ferrière
Service d'urologie, CHU de Bordeaux, place Amélie-Raba-Leon, 33000 Bordeaux, France. Electronic address: philippe.ballanger@chu-bordeaux.fr.
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Ballanger
Service d'urologie, CHU de Bordeaux, place Amélie-Raba-Leon, 33000 Bordeaux, France. Electronic address: gilles.pasticier@chu-bordeaux.fr.
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Pasticier
D005602:France; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D011468:Prostatectomy / Q000009:adverse effects*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D053825:Suburethral Slings; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology*; D013521:Urologic Surgical Procedures, Male / Q000379:methods
Bandelette sous-urétrale; Incontinence urinaire; Prostatectomie; Prostatectomy; Suburethral sling; Urinary incontinence