Effectiveness and Complications of the AMS AdVance™ Male Sling System for the Treatment of Stress Urinary Incontinence: A Prospective Multicenter Study

Haixia, Ye; Haab, F.; Ridder, Dirk De; Chauveau, P.; Becker, Armin J.; Arañó, Pedro; Haillot, O.; Fassi-Fehri, H.

doi:10.1016/j.urology.2018.06.035

Cited by 16 publications

(21 citation statements)

References 25 publications

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“…The urinary sphincter is still seen as the gold standard in the treatment of male urinary incontinence with good results in long‐term follow‐up and the first generation AdVance sling system was often criticized due to a suspected loss‐of‐function in long‐term follow‐up. For example, a current prospective trial showed a need for a second intervention in 12.4% of patients …”

Section: Introductionmentioning

confidence: 99%

Extended follow‐up of the AdVance XP male sling in the treatment of male urinary stress incontinence after 48 months: Results of a prospective and multicenter study

Grabbert

Mumm²,

Klehr³

et al. 2019

Neurourology and Urodynamics

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Objective To evaluate the efficacy and safety of the AdVance XP male sling in a midterm follow‐up for the treatment of male urinary incontinence in a selected patient cohort. Materials and Methods In all, 115 patients with postprostatectomy incontinence were prospectively enrolled. A previous endoscopic evaluation of a sufficient coaptive zone in the repositioning test was mandatory. Patients with urine leakage in supine position or previous incontinence surgery were excluded. Postoperatively a standardized 24‐hour pad test and pad usage were evaluated. To compare pre‐ and postoperative continence status nonparametric t test was used. A P‐value of <.05 was seen as statistically significant. Results Median preoperative urine loss in the 24‐hour pad test was 272 g (min. 42‐max. 1600) and was significantly improved at any point in follow‐up. Success was defined as 0 pads per day and a maximum of 5 g in the 24‐hour pad test. After a follow‐up of 48 months, 71.7% of the patients were cured, whereas 15.0% of patients had an improved continence situation and 13.3% were classified as failed. Mean urine loss decreased significantly to 24.4 g (P ≤ .001). No severe intra‐ or postoperative complications are to be reported. Median follow‐up was 4.2 years. Conclusions A stable effectiveness in a selected patient cohort can also be demonstrated in an extended follow‐up. The complication rates are low and no late postoperative complications occurred, indicating the safety of the procedure.

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Section: Introductionmentioning

confidence: 99%

Extended follow‐up of the AdVance XP male sling in the treatment of male urinary stress incontinence after 48 months: Results of a prospective and multicenter study

Grabbert

Mumm²,

Klehr³

et al. 2019

Neurourology and Urodynamics

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“…In a recent multi-institutional prospective trial, Ye et al reported that 2.7% of patients developed Clavien grade 3 or higher complications, 12.4% required secondary surgical procedures for incontinence at 24 months follow up, and 19.4% of patients were using two or more pads daily at 2 years follow up. 4 Ye et al…”

Section: Discussionmentioning

confidence: 99%

“…3,7,11 Studies have not previously evaluated whether obesity increases the strain on the mesh used for the AdVance sling; however, studies have suggested the importance of maintaining sufficient tension on the urethra. 4,12,13 As a result of this, we felt that evaluating the outcomes of obesity would be helpful to understand which patients can benefit most from placement of a urethral sling.…”

Section: Discussionmentioning

confidence: 99%

“…reported that 2.7% of patients developed Clavien grade 3 or higher complications, 12.4% required secondary surgical procedures for incontinence at 24 months follow up, and 19.4% of patients were using two or more pads daily at 2 years follow up. 4 Ye et al . reported acute postoperative urinary retention in 2.7% patients, similar to the current findings.…”

Section: Discussionmentioning

confidence: 99%

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Impact of obesity on male urethral sling outcomes

Monn

Jarvis

Gardner

et al. 2020

Therapeutic Advances in Urology

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Background: The impact of obesity on AdVance male urethral sling outcomes has been poorly evaluated. Anecdotally, male urethral sling placement can be more challenging due to body habitus in obese patients. The objective of this study was to evaluate the impact of obesity on surgical complexity using operative time as a surrogate and secondarily to evaluate the impact on postoperative pad use. Methods: A retrospective cohort analysis was performed using all men who underwent AdVance male urethral sling placement at a single institution between 2013 and 2019. Descriptive statistics comparing obese and non-obese patients were performed. Results: A total of 62 patients were identified with median (IQR) follow up of 14 (4–33) months. Of these, 40 were non-obese and 22 (35.5%) were obese. When excluding patients who underwent concurrent surgery, the mean operative times for the non-obese versus obese cohorts were 61.8 min versus 73.7 min ( p = 0.020). No Clavien 3–5 grade complications were noted. At follow up, 47.5% of the non-obese cohort and 63.6% of the obese cohort reported using one or more pads daily ( p = 0.290). Four of the five patients with a history of radiation were among the patients wearing pads following male urethral sling placement. Conclusion: Obese men undergoing AdVance male urethral sling placement required increased operative time, potentially related to operative complexity, and a higher proportion of obese compared with non-obese patients required postoperative pads for continued urinary incontinence. Further research is required to better delineate the full impact of obesity on male urethral sling outcomes.

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“…Stress urinary incontinence (SUI) persists long-term in approximately 20% of patients after radical prostatectomy and 10% of patients after prostate radiation (1)(2)(3)(4). Men with mild SUI are ideal candidates for transobturator slings (5)(6)(7)(8), while men with severe SUI are better suited for artificial urinary sphincters (AUS) (9)(10)(11). Men with moderate SUI, however, are often considered to be candidates for either sling or AUS (6,7,12,13).…”

Section: Introductionmentioning

confidence: 99%

Standing cough test stratification of moderate male stress urinary incontinence

Khouri

Ortiz

et al. 2021

Int. braz j urol.

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Purpose: Patient-reported history of pads per day (PPD) is widely recognized as a fundamental element of decision-making for anti-incontinence procedures. We hypothesize that SUI severity is often underestimated among men with moderate SUI. We sought to compare patient history of incontinence severity versus objective in-office physical examination findings. Materials and Methods: We retrospectively reviewed our single-surgeon male SUI surgical database from 2007-2019. We excluded patients with incomplete preoperative or postoperative data and those who reported either mild or severe SUI, thus having more straightforward surgical counseling. For men reported to have moderate SUI, we determined the frequency of upgrading SUI severity by recording the results of an in-office standing cough test (SCT) using the Male Stress Incontinence Grading Scale (MSIGS). The correlation of MSIGS with sling success rate was calculated. Failure was defined as >1 PPD usage or need for additional incontinence procedure. Results: Among 233 patients with reported moderate SUI (2-3 PPD), 89 (38%) had MSIGS 3-4 on SCT, indicating severe SUI. Among patients with 2-3 PPD preoperatively, sling success rates were significantly higher for patients with MSIGS 0-2 (76/116, 64%) compared to MSIGS 3-4 (6/18, 33%) (p <0.01). Conclusions: Many men with self-reported history of moderate SUI actually present severe SUI observed on SCT. The SCT is a useful tool to stratify moderate SUI patients to more accurately predict sling success.

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Effectiveness and Complications of the AMS AdVance™ Male Sling System for the Treatment of Stress Urinary Incontinence: A Prospective Multicenter Study

Cited by 16 publications

References 25 publications

Extended follow‐up of the AdVance XP male sling in the treatment of male urinary stress incontinence after 48 months: Results of a prospective and multicenter study

Extended follow‐up of the AdVance XP male sling in the treatment of male urinary stress incontinence after 48 months: Results of a prospective and multicenter study

Impact of obesity on male urethral sling outcomes

Standing cough test stratification of moderate male stress urinary incontinence

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