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Repeat retrourethral transobturator sling in the management of recurrent postprostatectomy stress urinary incontinence after failed first male sling.
Eur Urol. 2010 Nov; 58(5):767-72.EU

Abstract

BACKGROUND

A failure rate between 20% and 45.5% after retrourethral transobturator sling (RTS) is reported. Recommendations for the management of persistent or recurrent postprostatectomy stress urinary incontinence (SUI) after failed male sling do not exist.

OBJECTIVE

The aim of this study was the prospective evaluation of the efficacy of repeat RTS (RRTS) in patients after failed first RTS.

DESIGN, SETTING, AND PARTICIPANTS

Between March 2007 and August 2009, 35 patients with mild to severe SUI after failed first RTS were treated with a second AdVance sling (American Medical Systems, Minnetonka, MN, USA).

MEASUREMENTS

Preoperative and postoperative evaluation included daily pad use, 1-hr pad test, postvoiding residual (PVR) urine, uroflowmetry, and quality-of-life (QoL) scores.

RESULTS AND LIMITATIONS

After 6 mo, 45.5% (15 of 33 patients) showed no pad use; 30.3% (10 of 33 patients), one dry "security" pad; 3% (1 of 33 patients), one wet pad; 6.1% (2 of 33 patients), two pads; 3% (1 of 33 patients), pad reduction ≥50%; and 12.1% (4 of 33 patients), treatment failure. After 16.6 mo, 34.5% (10 of 29 patients) showed no pad use; 37.9% (11 of 29 patients), one dry "security" pad; 3.4% (1 of 29 patients), one wet pad; 3.4% (1 of 29 patients), two pads; 10.3% (3 of 29 patients), pad reduction ≥50%; and 10.4% (3 of 29 patients), treatment failure. Daily pad use and pad weight decreased significantly. PVR and uroflowmetry results showed no significant change. QoL improved significantly. Postoperative acute urinary retention was observed in 23.6% of patients.

CONCLUSIONS

RRTS is an effective and safe treatment option for the management of SUI after failed first RTS.

Authors+Show Affiliations

Department of Urology, Klinikum Grosshadern, Ludwig-Maximilian-University Munich, Munich, Germany. Irina.Soljanik@med.uni-muenchen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

20843598

Citation

Soljanik, Irina, et al. "Repeat Retrourethral Transobturator Sling in the Management of Recurrent Postprostatectomy Stress Urinary Incontinence After Failed First Male Sling." European Urology, vol. 58, no. 5, 2010, pp. 767-72.
Soljanik I, Becker AJ, Stief CG, et al. Repeat retrourethral transobturator sling in the management of recurrent postprostatectomy stress urinary incontinence after failed first male sling. Eur Urol. 2010;58(5):767-72.
Soljanik, I., Becker, A. J., Stief, C. G., Gozzi, C., & Bauer, R. M. (2010). Repeat retrourethral transobturator sling in the management of recurrent postprostatectomy stress urinary incontinence after failed first male sling. European Urology, 58(5), 767-72. https://doi.org/10.1016/j.eururo.2010.08.034
Soljanik I, et al. Repeat Retrourethral Transobturator Sling in the Management of Recurrent Postprostatectomy Stress Urinary Incontinence After Failed First Male Sling. Eur Urol. 2010;58(5):767-72. PubMed PMID: 20843598.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Repeat retrourethral transobturator sling in the management of recurrent postprostatectomy stress urinary incontinence after failed first male sling. AU - Soljanik,Irina, AU - Becker,Armin J, AU - Stief,Christian G, AU - Gozzi,Christian, AU - Bauer,Ricarda M, Y1 - 2010/09/01/ PY - 2010/05/31/received PY - 2010/08/20/accepted PY - 2010/9/17/entrez PY - 2010/9/17/pubmed PY - 2011/7/30/medline SP - 767 EP - 72 JF - European urology JO - Eur Urol VL - 58 IS - 5 N2 - BACKGROUND: A failure rate between 20% and 45.5% after retrourethral transobturator sling (RTS) is reported. Recommendations for the management of persistent or recurrent postprostatectomy stress urinary incontinence (SUI) after failed male sling do not exist. OBJECTIVE: The aim of this study was the prospective evaluation of the efficacy of repeat RTS (RRTS) in patients after failed first RTS. DESIGN, SETTING, AND PARTICIPANTS: Between March 2007 and August 2009, 35 patients with mild to severe SUI after failed first RTS were treated with a second AdVance sling (American Medical Systems, Minnetonka, MN, USA). MEASUREMENTS: Preoperative and postoperative evaluation included daily pad use, 1-hr pad test, postvoiding residual (PVR) urine, uroflowmetry, and quality-of-life (QoL) scores. RESULTS AND LIMITATIONS: After 6 mo, 45.5% (15 of 33 patients) showed no pad use; 30.3% (10 of 33 patients), one dry "security" pad; 3% (1 of 33 patients), one wet pad; 6.1% (2 of 33 patients), two pads; 3% (1 of 33 patients), pad reduction ≥50%; and 12.1% (4 of 33 patients), treatment failure. After 16.6 mo, 34.5% (10 of 29 patients) showed no pad use; 37.9% (11 of 29 patients), one dry "security" pad; 3.4% (1 of 29 patients), one wet pad; 3.4% (1 of 29 patients), two pads; 10.3% (3 of 29 patients), pad reduction ≥50%; and 10.4% (3 of 29 patients), treatment failure. Daily pad use and pad weight decreased significantly. PVR and uroflowmetry results showed no significant change. QoL improved significantly. Postoperative acute urinary retention was observed in 23.6% of patients. CONCLUSIONS: RRTS is an effective and safe treatment option for the management of SUI after failed first RTS. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/20843598/Repeat_retrourethral_transobturator_sling_in_the_management_of_recurrent_postprostatectomy_stress_urinary_incontinence_after_failed_first_male_sling_ DB - PRIME DP - Unbound Medicine ER -