title: Outcomes of Male Sling Mesh Kit Placement in Patients with Neuropathic Stress Urinary Incontinence: A Single Institution Experience.
abstract: OBJECTIVE
  The mainstay of therapy in patients with neuropathic stress urinary incontinence (nSUI) has been through the use of artificial urinary sphincter (AUS). AUS infection/erosion rates are higher in nSUI patients and these patients tend to be younger, increasing the likelihood of multiple AUS revisions in the future. We review our experience with mesh male slings for patients with nSUI.
  
  
  METHODS
  A retrospective review of patients who had mesh sling placement.
  
  
  RESULTS
  Twenty patients were identified between 2003 and 2011. 14/20 (70%) (5 = AdVance, 8 = InVance, 1 = Virtue) were available for long-term evaluation; in 6/20 (30%) the sling was removed for either infection or perineal wound breakdown. The mean time from injury to male sling was 148.2 (29-449) months. Pre-/post-op fluorourodynamic study was performed in 13 and 7 patients, respectively. There were no significant differences in ALPP (46.4 vs. 55.7 cm H2O, p = 0.106) and MCC (456.6 vs. 608 ml, p = 0.21) in the 7 patients who had a post-op study: five patients had new onset low bladder compliance and two had new onset detrusor overactivity post-sling. With a mean follow-up of 24.7 (1-66) months, 4/14 (28.6%) had no UI.
  
  
  CONCLUSIONS
  With short-term follow-up, mesh male slings are a feasible option to treat nSUI. There appears to be a lower success rate for UI resolution, which may be attributable to new onset detrusor failure or wound infection requiring sling removal.
authors.affiliation: University of Southern California, Los Angeles, Calif., USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Vainrib
authors.forename: Polina
authors.initials: P
authors.lastname: Reyblat
authors.forename: David
authors.initials: D
authors.lastname: Ginsberg
mesh_terms: D000293:Adolescent; D000328:Adult; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D053825:Suburethral Slings; D013997:Time Factors; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014554:Urination / Q000502:physiology*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D055815:Young Adult