Results of the AdVance transobturator male sling after radical prostatectomy and adjuvant radiotherapy.

Abstract

OBJECTIVES:

To prospectively evaluate the efficacy of the functional AdVance transobturator sling for the treatment of male stress urinary incontinence (SUI) in patients after radical prostatectomy and additional adjuvant radiotherapy.

METHODS:

Between February 2007 and November 2008, 24 patients with postprostatectomy SUI (ICS grade 2-4) and additional adjuvant radiotherapy were treated consecutively with the AdVance sling. Preoperatively, intensive workup, including urodynamic assessment and flexible urethroscopy, was performed. Physical examinations (pad test, uroflowmetry, ultrasound) and questionnaires (I-QOL score, ICIQ-UI-SF score) were performed during baseline and during follow-up. Cure rate was defined as no pad use or one dry pad, and improved rate as 1-2 pads or reduction of pads by ≥50%.

RESULTS:

After a median follow-up of 18.0 months (range 12-33 months, mean 18.8 months), the success rate was 50%. Daily pad use and pad weight in the 1-hour pad test decreased significantly. Patients with ICS grade 2 SUI exhibited a trend for a better success rate in comparison with patients with grade 3 and 4 SUI. Results were durable over time. Postoperatively, 16.7% of the patients exhibited transient acute urinary retention which resolved without further treatment after a maximum of 6 weeks. 1 sling had to be removed because of initial misplacement.

CONCLUSIONS:

In selected patients after adjuvant radiotherapy, the AdVance sling achieved a success rate of 50% and results were stable in a median follow-up of 18 months. Complication rates were low and comparable to complication rates for patients without additional radiotherapy.

• Authors: Ricarda M Bauer, Irina Soljanik, Claudius Füllhase, Alexander Buchner, Florian May, Christian G Stief, Christian Gozzi
• Journal: Urology (Urology) Vol. 77 Issue 2 Pg. 474-9 (Feb 2011) ISSN: 1527-9995 [Electronic] United States
• PMID: 21167563 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Topics

• Adult
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Prospective Studies
• Prostatectomy (adverse effects)
• Prosthesis Design
• Radiotherapy, Adjuvant (adverse effects)
• Suburethral Slings
• Urinary Incontinence, Stress (etiology, surgery)