Document Detail


AdVance/AdVance XP transobturator male slings: preoperative degree of incontinence as predictor of surgical outcome.
MedLine Citation:
PMID:  23465151     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the efficacy of the AdVance transobturator male sling in the treatment of male stress urinary incontinence and to identify the preoperative predictors of a successful outcome.
MATERIALS AND METHODS: All patients were considered for sling placement 1 year after radical prostatectomy or transurethral resection of the prostate. The degree of incontinence was assessed using the 24-hour pad weight test. A preoperative urodynamic assessment and cystoscopy were performed in all cases. Patients without sphincter contractions during the "repositioning test" were excluded. Since September 2010, we have implanted the AdVance XP transobturator sling. Cure was defined as no pad use.
RESULTS: From February 2008 to June 2011, 61 patients underwent transobturator sling (34 AdVance and 27 AdVance XP) insertion. In 26 cases, the sling was anchored with bioabsorbable sutures, and in 35 cases, it was not fixed. Of the 61 patients, 7 had a history of anastomotic stricture and 3 of radiotherapy. Preoperatively, median 24-hour pad weight was 200 g (range 25-1848). Finally, 26 patients had detrusor overactivity or low bladder compliance. The median follow-up was 26 months (range 12-53). The overall cure rate was 80% (49 of 61). Deterioration of continence was observed during follow-up in 2 patients. The preoperative variables (age, body mass index, 24-hour pad weight, International Consultation on Incontinence Questionnaire-Short Form, adverse urodynamics, sling fixation, AdVance XP) and their association with the surgical outcome were analyzed. The preoperative 24-hour pad weight correlated inversely with the outcome (odds ratio 0.996), with a 0.4% decrease in cure rate for each 1-g increase in the preoperative 24-hour pad weight. The complications included perineal hematoma in 2, acute urinary retention in 9, perineal numbness in 5, and de novo storage symptoms (urgency) in 5 patients.
CONCLUSION: The results of our study have shown that the AdVance and AdVance XP male slings are safe and efficient in patients with mild postprostatectomy stress incontinence. The severity of incontinence was the only predictor of a successful outcome.
Authors:
Argimiro Collado Serra; Luís Resel Folkersma; José L Domínguez-Escrig; Alvaro Gómez-Ferrer; José Rubio-Briones; Eduardo Solsona Narbón
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2013-03-07
Journal Detail:
Title:  Urology     Volume:  81     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-23     Completed Date:  2013-06-18     Revised Date:  2013-12-20    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1034-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications
Prostatectomy / adverse effects*
Prosthesis Design
Quality of Life*
Questionnaires
Retrospective Studies
Suburethral Slings*
Time Factors
Treatment Outcome
Urinary Incontinence, Stress / etiology,  surgery*
Urodynamics
Comments/Corrections
Comment In:
J Urol. 2013 Dec;190(6):2146   [PMID:  24209540 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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