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Treatment of postprostatectomy male urinary incontinence with the transobturator retroluminal repositioning sling suspension: 3-year follow-up.
Eur Urol. 2012 Jul; 62(1):140-5.EU

Abstract

BACKGROUND

The AdVance male sling (American Medical Systems, Minnetonka, MN, USA) has been shown to be an efficacious device in short-term studies for postprostatectomy incontinence (PPI), but long-term studies are lacking.

OBJECTIVE

Examine the intermediate-term outcome with the AdVance sling for PPI management.

DESIGN, SETTING, AND PARTICIPANTS

A multicentre prospective evaluation was conducted on consecutive patients treated for PPI in three European tertiary reference centres.

INTERVENTION

Patients were implanted with the AdVance male sling with no associated surgery.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Measurements included daily pad usage, maximum flow rate (Qmax), postvoid residual urine (PVR), the International Consultation on Incontinence Questionnaire-Short Form, the Incontinence Quality of Life questionnaires, and complications of surgery. Paired Wilcoxon signed rank test univariable and multivariable analyses were used.

RESULTS AND LIMITATIONS

Follow-up was available for 156 patients for the majority of parameters. Pad usage was significantly decreased compared with baseline at 12 mo and 3 yr (p<0.0001). At 12 mo, 76.9% of patients could be classified as cured or improved; this percentage was maintained at 3 yr (76.8%). Cure rates (58.6% vs 42.3%) and improvement rates (23.2% vs 25.0%) were higher in patients with mild or moderate incontinence compared with severe incontinence. Univariable analysis showed that pretreatment pad usage and severity of incontinence were both significant predictors of success (p=0.0355 and p=0.0420, respectively). However, in multivariable analysis, only pad usage was an independent predictor of success. There were no perioperative or severe postoperative complications. Most complications were Dindo grade I. Seven patients required a second treatment for stress urinary incontinence. There was no worsening over time. Limitations of this study included no comparator group, quality of life questionnaires in only two centres, and no 24-h pad test.

CONCLUSIONS

The transobturator retroluminal repositioning sling suspension is effective and safe in the longer term for treating PPI.

Authors+Show Affiliations

Department of Urology, Medical University, Innsbruck, Austria.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

22386196

Citation

Rehder, Peter, et al. "Treatment of Postprostatectomy Male Urinary Incontinence With the Transobturator Retroluminal Repositioning Sling Suspension: 3-year Follow-up." European Urology, vol. 62, no. 1, 2012, pp. 140-5.
Rehder P, Haab F, Cornu JN, et al. Treatment of postprostatectomy male urinary incontinence with the transobturator retroluminal repositioning sling suspension: 3-year follow-up. Eur Urol. 2012;62(1):140-5.
Rehder, P., Haab, F., Cornu, J. N., Gozzi, C., & Bauer, R. M. (2012). Treatment of postprostatectomy male urinary incontinence with the transobturator retroluminal repositioning sling suspension: 3-year follow-up. European Urology, 62(1), 140-5. https://doi.org/10.1016/j.eururo.2012.02.038
Rehder P, et al. Treatment of Postprostatectomy Male Urinary Incontinence With the Transobturator Retroluminal Repositioning Sling Suspension: 3-year Follow-up. Eur Urol. 2012;62(1):140-5. PubMed PMID: 22386196.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of postprostatectomy male urinary incontinence with the transobturator retroluminal repositioning sling suspension: 3-year follow-up. AU - Rehder,Peter, AU - Haab,Francois, AU - Cornu,Jean-Nicolas, AU - Gozzi,Christian, AU - Bauer,Ricarda M, Y1 - 2012/02/25/ PY - 2011/12/18/received PY - 2012/02/16/accepted PY - 2012/3/6/entrez PY - 2012/3/6/pubmed PY - 2012/12/12/medline SP - 140 EP - 5 JF - European urology JO - Eur Urol VL - 62 IS - 1 N2 - BACKGROUND: The AdVance male sling (American Medical Systems, Minnetonka, MN, USA) has been shown to be an efficacious device in short-term studies for postprostatectomy incontinence (PPI), but long-term studies are lacking. OBJECTIVE: Examine the intermediate-term outcome with the AdVance sling for PPI management. DESIGN, SETTING, AND PARTICIPANTS: A multicentre prospective evaluation was conducted on consecutive patients treated for PPI in three European tertiary reference centres. INTERVENTION: Patients were implanted with the AdVance male sling with no associated surgery. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Measurements included daily pad usage, maximum flow rate (Qmax), postvoid residual urine (PVR), the International Consultation on Incontinence Questionnaire-Short Form, the Incontinence Quality of Life questionnaires, and complications of surgery. Paired Wilcoxon signed rank test univariable and multivariable analyses were used. RESULTS AND LIMITATIONS: Follow-up was available for 156 patients for the majority of parameters. Pad usage was significantly decreased compared with baseline at 12 mo and 3 yr (p<0.0001). At 12 mo, 76.9% of patients could be classified as cured or improved; this percentage was maintained at 3 yr (76.8%). Cure rates (58.6% vs 42.3%) and improvement rates (23.2% vs 25.0%) were higher in patients with mild or moderate incontinence compared with severe incontinence. Univariable analysis showed that pretreatment pad usage and severity of incontinence were both significant predictors of success (p=0.0355 and p=0.0420, respectively). However, in multivariable analysis, only pad usage was an independent predictor of success. There were no perioperative or severe postoperative complications. Most complications were Dindo grade I. Seven patients required a second treatment for stress urinary incontinence. There was no worsening over time. Limitations of this study included no comparator group, quality of life questionnaires in only two centres, and no 24-h pad test. CONCLUSIONS: The transobturator retroluminal repositioning sling suspension is effective and safe in the longer term for treating PPI. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/22386196/Treatment_of_postprostatectomy_male_urinary_incontinence_with_the_transobturator_retroluminal_repositioning_sling_suspension:_3_year_follow_up_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(12)00232-1 DB - PRIME DP - Unbound Medicine ER -