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The bone anchor suburethral synthetic sling for iatrogenic male incontinence: critical evaluation at a mean 3-year followup.
J Urol. 2009 May; 181(5):2204-8.JU

Abstract

PURPOSE

We retrospectively report objective and subjective outcomes in 40 male patients who underwent bone anchored suburethral synthetic sling positioning for stress urinary incontinence due to intrinsic sphincter deficiency.

MATERIALS AND METHODS

Patients with stress urinary incontinence due to radical retropubic prostatectomy (32), robot assisted laparoscopic prostatectomy (3) and transurethral prostate resection (5) underwent bone anchored suburethral synthetic sling positioning between December 2002 and December 2007. Mean followup was 35.2 months (range 2 to 62). Previous anti-incontinence procedures, radiotherapy and transurethral procedures due to urethral stricture were performed in 5, 11 and 5 patients, respectively. Before and after surgery patients were evaluated by physical examination, urethral cystoscopy, urodynamics, a 1-hour pad test and a quality of life questionnaire. Patients were stratified into 3 groups, including group 1-cured (dry with a pad weight of 0 to 1 gm), group 2-improved (mild to moderate incontinence with a pad weight of 2 to 50 gm) and group 3-failed (patient condition unchanged with a pad weight of greater than 50 gm).

RESULTS

At the final followup visit 22 (55%), 5 (12.5%) and 13 patients (32.5%) were cured, improved and failed, respectively. Mean pad weight significantly decreased to 51.3 gm in 54% of cases, while the mean total questionnaire score significantly increased to 72.9 in 65% and abdominal leak point pressure significantly increased to 92.5 cm H(2)O in 52%. Statistical analysis showed a significant association between preoperative radiotherapy and treatment failure (85% of patients). Complications were perineal pain in 73% of cases, detrusor overactivity in 5% and sling infection in 15%.

CONCLUSIONS

The bone anchored suburethral synthetic sling is a simple and attractive procedure that can produce immediate good results with low morbidity, especially when strictly selected patients are treated. Radiotherapy remains a strong predictor of failure.

Authors+Show Affiliations

Department of Surgery, Division of Urology, San Paolo Hospital, Savona, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

19296976

Citation

Giberti, Claudio, et al. "The Bone Anchor Suburethral Synthetic Sling for Iatrogenic Male Incontinence: Critical Evaluation at a Mean 3-year Followup." The Journal of Urology, vol. 181, no. 5, 2009, pp. 2204-8.
Giberti C, Gallo F, Schenone M, et al. The bone anchor suburethral synthetic sling for iatrogenic male incontinence: critical evaluation at a mean 3-year followup. J Urol. 2009;181(5):2204-8.
Giberti, C., Gallo, F., Schenone, M., Cortese, P., & Ninotta, G. (2009). The bone anchor suburethral synthetic sling for iatrogenic male incontinence: critical evaluation at a mean 3-year followup. The Journal of Urology, 181(5), 2204-8. https://doi.org/10.1016/j.juro.2009.01.022
Giberti C, et al. The Bone Anchor Suburethral Synthetic Sling for Iatrogenic Male Incontinence: Critical Evaluation at a Mean 3-year Followup. J Urol. 2009;181(5):2204-8. PubMed PMID: 19296976.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The bone anchor suburethral synthetic sling for iatrogenic male incontinence: critical evaluation at a mean 3-year followup. AU - Giberti,Claudio, AU - Gallo,Fabrizio, AU - Schenone,Maurizio, AU - Cortese,Pieluigi, AU - Ninotta,Gaetano, Y1 - 2009/03/17/ PY - 2008/08/29/received PY - 2009/3/20/entrez PY - 2009/3/20/pubmed PY - 2009/5/5/medline SP - 2204 EP - 8 JF - The Journal of urology JO - J. Urol. VL - 181 IS - 5 N2 - PURPOSE: We retrospectively report objective and subjective outcomes in 40 male patients who underwent bone anchored suburethral synthetic sling positioning for stress urinary incontinence due to intrinsic sphincter deficiency. MATERIALS AND METHODS: Patients with stress urinary incontinence due to radical retropubic prostatectomy (32), robot assisted laparoscopic prostatectomy (3) and transurethral prostate resection (5) underwent bone anchored suburethral synthetic sling positioning between December 2002 and December 2007. Mean followup was 35.2 months (range 2 to 62). Previous anti-incontinence procedures, radiotherapy and transurethral procedures due to urethral stricture were performed in 5, 11 and 5 patients, respectively. Before and after surgery patients were evaluated by physical examination, urethral cystoscopy, urodynamics, a 1-hour pad test and a quality of life questionnaire. Patients were stratified into 3 groups, including group 1-cured (dry with a pad weight of 0 to 1 gm), group 2-improved (mild to moderate incontinence with a pad weight of 2 to 50 gm) and group 3-failed (patient condition unchanged with a pad weight of greater than 50 gm). RESULTS: At the final followup visit 22 (55%), 5 (12.5%) and 13 patients (32.5%) were cured, improved and failed, respectively. Mean pad weight significantly decreased to 51.3 gm in 54% of cases, while the mean total questionnaire score significantly increased to 72.9 in 65% and abdominal leak point pressure significantly increased to 92.5 cm H(2)O in 52%. Statistical analysis showed a significant association between preoperative radiotherapy and treatment failure (85% of patients). Complications were perineal pain in 73% of cases, detrusor overactivity in 5% and sling infection in 15%. CONCLUSIONS: The bone anchored suburethral synthetic sling is a simple and attractive procedure that can produce immediate good results with low morbidity, especially when strictly selected patients are treated. Radiotherapy remains a strong predictor of failure. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/19296976/The_bone_anchor_suburethral_synthetic_sling_for_iatrogenic_male_incontinence:_critical_evaluation_at_a_mean_3_year_followup_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2009.01.022?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -