title: 36-month data for the AdVance XP®male sling: results of a prospective multicentre study.
abstract: To evaluate the efficacy and safety of the AdVance XP®sling (Boston Scientific, formerly American Medical Systems) in male stress urinary incontinence (SUI) after radical prostatectomy in a prospective multicentre study, as in recent years several studies have shown the effectiveness and safety of the AdVance sling for treating male SUI and in 2010 the second-generation AdVance XP was introduced with several changes in the sling design and a new needle shape.
  
  
  
  In all, 115 patients were included. Patients with nocturnal UI, previous UI surgery, previous radiotherapy and a coaptive zone of <1 cm in the preoperative repositioning test were excluded. Postoperatively, a standardised 24-h pad test, quality-of-life scores [International Quality of Life score (IQOL) and International Consultation on Incontinence Questionnaire short form (ICIQ-UI SF)], visual analogue scale (VAS) for pain, five-item version of the International Index of Erectile Function (IIEF-5), International Prostate Symptom Score (IPSS) and Patient Global Impression of Improvement (PGI-I) score, were performed. All patients with a 0-5 g pad test were defined as cured and improved with a reduction of urine loss of >50%. All others were classified as failures. Significance analysis was performed using the Wilcoxon test.
  
  
  
  The mean (median) preoperative urine loss in the 24-h pad test was 272.0 (272.0) g. After a follow-up of 3 months (114 patients), 64.9% of the patients were cured and 31.6% had an improved continence status. The mean urine loss decreased significantly to 34.9 g (P < 0.001), with a mean VAS score of 0.5, and mean PGI-I of 1.5. After a follow-up of 24 months (80 patients), 68.8% of the patients were cured and 22.5% had improved. The mean urine loss decreased significantly to 19.1 g (P < 0.001), with a mean VAS score of 0.3, and mean PGI-I of 1.5. After a follow-up of 36 months (47 patients), 66.0% of the patients were cured and 23.4% had improved. The mean urine loss decreased significantly to 21.8 g (P < 0.001), with a mean VAS score of 0.0, and mean PGI-I of 1.6. The mean IQOL and ICIQ-UI SF improved significantly (both P < 0.001) after 36 months. There were no significant postoperative changes in IIEF-5 and IPSS. No intraoperative and no long-term complications occurred. No erosion or explanations occurred.
  
  
  
  The AdVance XP shows good and stable effectiveness and low complication rates even at a mid-term follow-up of up to 36 months.
authors.affiliation: Ludwig-Maximlians-University Munich (LMU), Munich, Germany.
authors.forename: Ricarda M
authors.initials: RM
authors.lastname: Bauer
authors.affiliation: Ludwig-Maximlians-University Munich (LMU), Munich, Germany.
authors.forename: Markus T
authors.initials: MT
authors.lastname: Grabbert
authors.affiliation: Ludwig-Maximlians-University Munich (LMU), Munich, Germany.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Klehr
authors.affiliation: Landeskrankenhaus Vocklabruck, Vocklabruck, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Gebhartl
authors.affiliation: Department of Urology, Marienklinik Bozen, Bolzano, Italy.
authors.forename: Christian
authors.initials: C
authors.lastname: Gozzi
authors.affiliation: Department of Urology and Paediatric Urology, St. Barbara Hospital Hamm GmbH, Hamm, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Homberg
authors.affiliation: Klinikum Dachau, Dachau, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: May
authors.affiliation: Department of Urology, University of Innsbruck, Innsbruck, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Rehder
authors.affiliation: Ludwig-Maximlians-University Munich (LMU), Munich, Germany.
authors.forename: Christian G
authors.initials: CG
authors.lastname: Stief
authors.affiliation: Ludwig-Maximlians-University Munich (LMU), Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kretschmer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*
keywords: #Incontinence; AdVance XP; efficacy; male sling; post-prostatectomy incontinence; radical prostatectomy; safety