Document Detail


The male sling for post-prostatectomy urinary incontinence: a review of contemporary sling designs and outcomes.
MedLine Citation:
PMID:  22004176     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
What's known on the subject? and What does the study add? Long-term cure and improved rates for the bone anchored sling range from 40-88%. Midterm cure and improved rates for the retrourethral transobturator sling rage from 76-91%. Midterm cure and improved rates for the adjustable retropubic sling rage from 72-79%. Potential complications common to all urethral slings include postoperative urinary retention, perineal pain, and urethral erosion/device infection. All male urethral slings have primarily been studied in post radical prostatectomy patients, with inconsistent success among patients with prior pelvic radiation. OBJECTIVE: •  To examine the outcomes and adverse events associated with novel male sling designs described in the last decade. METHODS: •  A literature review was carried out using Medline, EmBase, Cochrane Registered Trials Database and the Center for Reviews and Dissemination Database. RESULTS: •  Three principal slings are described in the literature. The bone-anchored sling has success rates of 40-88%, with some series having a mean follow-up of 36-48 months. It is associated with a mesh infection rate of 2-12%, which usually requires sling explantation. •  The retrourethral transobturator sling has a success rate of 76-91% among three large case series with follow-ups of 12-27 months. There is a low reported explantation rate. •  The adjustable retropubic sling has a success rate of 72-79% with follow-ups of 26-45 months. Erosion (3-13%) and infection (3-11%) can lead to explantation. CONCLUSIONS: •  Most male slings have a similar reported efficacy. Most case series define success as either dry or improved. True cure rates are lower. Mid- and long-term data are now available that indicate the male sling is a viable option for PPI. •  The use of male slings in severe UI, radiated patients, and non-radical prostatectomy patients is still unclear. Further study is needed to try and define criteria for the use of male slings, and to directly compare different procedures.
Authors:
Blayne K Welk; Sender Herschorn
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-17
Journal Detail:
Title:  BJU international     Volume:  -     ISSN:  1464-410X     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.
Affiliation:
Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
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