Male Readjustable Sling (MRS) System for Postprostatectomy Incontinence: Experiences of 2 Centers.
OBJECTIVE
To evaluate the outcomes of Male Readjustable Sling (MRS) in patients with postprostatectomy incontinence at 2 unrelated centers and to determine preoperative factors relevant to the outcome.


METHODS
From January 2007 to January 2014, a total of 64 men with urinary incontinence following radical prostatectomy were treated with MRS at 2 centers. Patients were evaluated based on medical history, daily pad usage, urodynamics, and cystoscopy. The clinical outcome was evaluated according to daily pad usage and questionnaires. Success was defined according to reductions in the number of pads used per day after surgery, and factors related to surgical outcome were investigated.


RESULTS
The median age of the patients was 70 years (range: 53-84), and the mean follow-up duration was 46.0 ± 19.47 months (range: 12-89). During follow-up, readjustment of the sling was required 1.9 times on average. Daily pad usage decreased significantly from 3.42 ± 2.00 to 0.84 ± 1.20 (P <.001), and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form score improved (18.65 ± 2.61 to 10.55 ± 6.21, P <.001) without deterioration of voiding symptoms at the last follow-up. MRS was successful in 46 of 64 patients (71.9%). Of the 18 patients who experienced surgical failure, 12 patients required secondary artificial urethral sphincter implantation. The number of daily used pads (odds ratio 1.414) and a history of pelvic irradiation (odds ratio 8.400) were potential risk factors for surgical failure.


CONCLUSIONS
According to our midterm follow-up data, MRS is an effective and a safe treatment option for radiation-naïve patients with a mild degree of postprostatectomy incontinence.
Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Sang Woon
SW
Kim
Department of Urology, Barnabas Health Medical Center, Livingston, NJ.
Rhonda
R
Walsh
Department of Urology, Barnabas Health Medical Center, Livingston, NJ.
Yitzhak
Y
Berger
Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: JKIM@yuhs.ac.
Jang Hwan
JH
Kim
D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D053825:Suburethral Slings; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*