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The inside-out trans-obturator sling: a novel surgical technique for the treatment of male urinary incontinence.
Eur Urol. 2008 Nov; 54(5):1051-65.EU

Abstract

OBJECTIVES

To describe a new sling procedure for treating stress urinary incontinence (SUI) after radical prostatectomy (RP) and prospectively evaluate its short-term safety and efficacy.

METHODS

The sling technique uses specific instruments and a polypropylene mesh with two arms that are passed inside to outside through the obturator foramens, pulled for compressing the bulbar urethra upward, and tied to each other across the midline. Patients with detrusor overactivity were excluded. Baseline and follow-up evaluations included uroflowmetry and continence and quality of life (QoL) questionnaires. Cure was defined by no pad use and improvement by a number of pads/d <or=2 and reduced by at least 50%. Complications were recorded.

RESULTS

From April 2006 through February 2007, 20 consecutive patients suffering from post-RP SUI underwent the sling procedure using the same operative protocol. Preoperatively, 3 (15%), 11 (55%), and 6 (25%) patients were using 2, 3-5, and >5pads/d, respectively. The procedure was preceded by an endoscopic urethrotomy in four patients. No perioperative complication was noted; three patients required suprapubic catheterization. At 6 mo, nine (45%) patients were cured and eight others (40%) were improved (1pad/d). QoL was significantly enhanced and 80% of patients were moderately to completely satisfied with the procedure. Preoperative and postoperative maximum flow rate and postvoid residual values were not statistically different. No sling infection, urethra erosion, persistent pain, or neurologic complications were observed.

CONCLUSIONS

The inside-out trans-obturator sling procedure appears to be safe and efficient at short term. Further studies are warranted to determine long-term outcome.

Authors+Show Affiliations

Department of Urology, University of Liège, Liège, Belgium. Jean.deLeval@ulg.ac.beNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18036729

Citation

de Leval, Jean, and David Waltregny. "The Inside-out Trans-obturator Sling: a Novel Surgical Technique for the Treatment of Male Urinary Incontinence." European Urology, vol. 54, no. 5, 2008, pp. 1051-65.
de Leval J, Waltregny D. The inside-out trans-obturator sling: a novel surgical technique for the treatment of male urinary incontinence. Eur Urol. 2008;54(5):1051-65.
de Leval, J., & Waltregny, D. (2008). The inside-out trans-obturator sling: a novel surgical technique for the treatment of male urinary incontinence. European Urology, 54(5), 1051-65.
de Leval J, Waltregny D. The Inside-out Trans-obturator Sling: a Novel Surgical Technique for the Treatment of Male Urinary Incontinence. Eur Urol. 2008;54(5):1051-65. PubMed PMID: 18036729.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The inside-out trans-obturator sling: a novel surgical technique for the treatment of male urinary incontinence. AU - de Leval,Jean, AU - Waltregny,David, Y1 - 2007/11/20/ PY - 2007/10/30/received PY - 2007/11/07/accepted PY - 2007/11/27/pubmed PY - 2009/1/15/medline PY - 2007/11/27/entrez SP - 1051 EP - 65 JF - European urology JO - Eur Urol VL - 54 IS - 5 N2 - OBJECTIVES: To describe a new sling procedure for treating stress urinary incontinence (SUI) after radical prostatectomy (RP) and prospectively evaluate its short-term safety and efficacy. METHODS: The sling technique uses specific instruments and a polypropylene mesh with two arms that are passed inside to outside through the obturator foramens, pulled for compressing the bulbar urethra upward, and tied to each other across the midline. Patients with detrusor overactivity were excluded. Baseline and follow-up evaluations included uroflowmetry and continence and quality of life (QoL) questionnaires. Cure was defined by no pad use and improvement by a number of pads/d <or=2 and reduced by at least 50%. Complications were recorded. RESULTS: From April 2006 through February 2007, 20 consecutive patients suffering from post-RP SUI underwent the sling procedure using the same operative protocol. Preoperatively, 3 (15%), 11 (55%), and 6 (25%) patients were using 2, 3-5, and >5pads/d, respectively. The procedure was preceded by an endoscopic urethrotomy in four patients. No perioperative complication was noted; three patients required suprapubic catheterization. At 6 mo, nine (45%) patients were cured and eight others (40%) were improved (1pad/d). QoL was significantly enhanced and 80% of patients were moderately to completely satisfied with the procedure. Preoperative and postoperative maximum flow rate and postvoid residual values were not statistically different. No sling infection, urethra erosion, persistent pain, or neurologic complications were observed. CONCLUSIONS: The inside-out trans-obturator sling procedure appears to be safe and efficient at short term. Further studies are warranted to determine long-term outcome. SN - 0302-2838 UR - https://www.unboundmedicine.com/medline/citation/18036729/The_inside_out_trans_obturator_sling:_a_novel_surgical_technique_for_the_treatment_of_male_urinary_incontinence_ DB - PRIME DP - Unbound Medicine ER -