Long-term Outcome of the Retrourethral Transobturator Male Sling After Transurethral Resection of the Prostate.
- Author:
Alexander KRETSCHMER
1
;
Alexander BUCHNER
;
Benedikt LEITL
;
Markus GRABBERT
;
Anne SOMMER
;
Wael KHODER
;
Christian GOZZI
;
Christian G STIEF
;
Ricarda M BAUER
Author Information
- Publication Type:Original Article
- Keywords: Urinary Stress, Incontinence; Suburethral Slings; Transurethral Resection of the Prostate; Complications
- MeSH: Follow-Up Studies; Humans; Male*; Patient Satisfaction; Prostate*; Prostatectomy; Quality of Life; Suburethral Slings*; Transurethral Resection of Prostate; Urinary Incontinence
- From:International Neurourology Journal 2016;20(4):335-341
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: 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.
