title: Long-term Outcome of the Retrourethral Transobturator Male Sling After Transurethral Resection of the Prostate.
abstract: OBJECTIVE
  To evaluate long-term outcomes of AdVance and AdVanceXP male slings in patients with persistent stress urinary incontinence (SUI) after transurethral resection of the prostate (TURP).
  
  
  METHODS
  A total of 18 consecutive patients received AdVance (n=14) or AdVanceXP (n=4) male sling implantation between 2007 and 2013. Continence was determined by pad use, 24-hour pad testing and validated questionnaires (International Consultation on Incontinence Questionnaire Short Form, ICIQ-SF). Quality of life was evaluated by International Quality of Life (IQoL) score. Patient satisfaction was measured with patient's global impression of improvement score. Cure was defined as 0-5 g in the 24-hour pad test. Statistical analysis included Fisher exact and Wilcoxon test (P<0.05).
  
  
  RESULTS
  Follow-up was available for 15 patients who underwent further analysis. After a median follow-up of 70 months (range, 18-83 months), mean daily pad usage was 1.8±2.1 pads (P=0.015 vs. baseline level). Mean IQoL score was 66.4±31.6 (P=0.050 vs. baseline level), and mean ICIQ-SF score was 9.5±6.6 (P=0.077 vs. baseline level). Based on 24-hour pad testing, mean daily urine loss was 31.2±64.5 g (median, 0 g; range, 0-209 g). Cure rate was 46.7%, and cure-and-improved rate was 60.0%. Assessing predictive features for success, better results were found in patients who needed up to 4 pads preoperatively (P=0.041) as well as for patients ≤71 years at the time of implantation (P=0.041).
  
  
  CONCLUSIONS
  The findings indicate that AdVance and AdVanceXP implantation can be performed effectively and safely in men suffering from SUI after TURP. However, long-term success rates seem to be lower compared to SUI after radical prostatectomy and patients should be counseled accordingly.
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Munich, Germany.|Department of Urological Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada.
authors.forename: Alexander
authors.identifier: 0000-0002-6511-4354
authors.initials: A
authors.lastname: Kretschmer
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Alexander
authors.identifier: 0000-0001-7895-7070
authors.initials: A
authors.lastname: Buchner
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Benedikt
authors.identifier: 0000-0002-5020-5405
authors.initials: B
authors.lastname: Leitl
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Markus
authors.identifier: 0000-0002-7059-6124
authors.initials: M
authors.lastname: Grabbert
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Anne
authors.identifier: 0000-0003-3913-1035
authors.initials: A
authors.lastname: Sommer
authors.affiliation: Department of Urology, Johann-Wolfgang Goethe University, Frankfurt, Germany.
authors.forename: Wael
authors.identifier: 0000-0002-8813-8981
authors.initials: W
authors.lastname: Khoder
authors.affiliation: Department of Urology, Marienklinik, Bolzano, Italy.
authors.forename: Christian
authors.identifier: 0000-0001-7544-5942
authors.initials: C
authors.lastname: Gozzi
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Christian G
authors.identifier: 0000-0003-3291-9460
authors.initials: CG
authors.lastname: Stief
authors.affiliation: Department of Urology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Ricarda M
authors.identifier: 0000-0001-9911-1728
authors.initials: RM
authors.lastname: Bauer
keywords: Complications; Suburethral Slings; Transurethral Resection of the Prostate; Urinary Stress, Incontinence