Efficacy and Complications of the Adjustable Sling System ArgusT for Male Incontinence: Results of a Prospective 2-Center Study

Bauer, Ricarda M.; Rutkowski, Michael; Kretschmer, Alexander; Casuscelli, Jozefina; Stief, Christian G.; Huebner, Wilhelm

doi:10.1016/j.urology.2014.10.019

Cited by 42 publications

(38 citation statements)

References 14 publications

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“…However, with a 77% 1-year cure and improvement rate for the IPI and 89% cure and improvement rate for the SPI, the results are comparable with current literature [2,3,14,15,16,17,18]. Romano et al [16] and Bauer et al [15] recently published similar results with the Argus-T with maximum follow-up time of 30 months. Leruth et al [14] published in 2012 the 2-year follow-up data of the de Leval and Waltregny sling (TOM sling); 49% dry rate and 33 > 50% improvement rate: 82% success rate.…”

Section: Discussionsupporting

confidence: 86%

Argus-T Adjustable Male Sling: The Influence of Surgical Technique on Complications and Short-Term Efficacy

Cornel

2016

Urol Int

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Objectives: The study aims to investigate and evaluate the influence of 2 different methods of implantation of the Argus transobturator (Argus-T) adjustable male sling on complication rate and short-term efficacy. Methods: A prospective mono-center evaluation was conducted on consecutive patients treated for persistent post-radical prostatectomy incontinence. Thirty-six patients were implanted with the Argus-T adjustable male sling - 18 by inguinal-perineal incision (IPI) and 18 by single-perineal incision (SPI). Measurements included 24-hour frequency volume micturition list, 24-hour pad test, 24-hour pad count, Visual Analogue Scale for continence and satisfaction, flowmetry and residual voided urine. Results: Cure rate for IPI and SPI at 1, 6 and 12 months was 67, 75, 62% and 59, 63, 63%, respectively (no statistically significant difference). Although more clinically significant complications were seen in the IPI group, a statistical significant difference was observed only for wound infection between the IPI and the SPI groups (33 vs. 0%, p = 0.019). Conclusions: The Argus-T male sling SPI suspension operation is a minimally invasive and safe procedure for the management of male postoperative stress incontinence which is highly appreciated by the patients.

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Section: Discussionsupporting

confidence: 86%

Argus-T Adjustable Male Sling: The Influence of Surgical Technique on Complications and Short-Term Efficacy

Cornel

2016

Urol Int

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“…Addressing this topic, Bochove-Overgaauw and Schrier [13] analyzed the outcome after 100 Argus classic implantations and described bladder perforations in 6%. Considering the different surgical approaches, it seems intuitive that bladder perforations occur much less frequently during Argus T implantation [11]. …”

Section: Discussionmentioning

confidence: 99%

“…The Argus classic system (Promedon, Cordoba, Argentina) is a radiopaque cushioned system with a silicone foam pad for soft compression of the bulbar urethra and is implanted via a retropubical approach [10]. The Argus T sling system (Promedon) was launched in 2008 and differs in terms of implantation route (transobturatoric approach) and the position of the washers [11]. …”

Section: Introductionmentioning

confidence: 99%

Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Perioperative Complications and Device Explantations

et al. 2017

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PurposeTo analyze perioperative complications and postoperative explantation rates for selected readjustable male sling systems and the perineal single-cuff artificial urinary sphincter (AUS) in a large, contemporary, multi-institutional patient cohort. MethodsTwo hundred eighty-two male patients who underwent implantation between 2010 and 2012 in 13 participating institutions were included in the study (n=127 adjustable male sling [n=95 Argus classic, n=32 Argus T], n=155 AUS). Perioperative characteristics and postoperative complications were analyzed. The explantation rates of the respective devices were assessed using the Fisher exact test and the Mann-Whitney U-test. A Kaplan-Meier curve was generated. Potential features associated with device explantation were analyzed using a multiple logistic regression model (P<0.05). ResultsWe found significantly increased intraoperative complication rates after adjustable male sling implantation (15.9% [adjustable male sling] vs. 4.2% [AUS], P=0.003). The most frequent intraoperative complication was bladder perforation (n=17). Postoperative infection rates did not vary significantly between the respective devices (P=0.378). Device explantation rates were significantly higher after AUS implantation (9.7% [adjustable male sling] vs. 21.5% [AUS], P=0.030). In multivariate analysis, postoperative infection was a strong independent predictor of decreased device survival (odds ratio, 6.556; P=0.001). ConclusionsComplication profiles vary between adjustable male slings and AUS. Explantation rates are lower after adjustable male sling implantation. Any kind of postoperative infections are independent predictors of decreased device survival. There is no significant effect of the experience of the implanting institution on device survival.

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“…Therefore, a thorough planning of the surgical approach should be taken into consideration in this cohort of patients to minimize further complications. Various prospective studies of MS exclude prior urethral strictures [14,22] . Cornu et al [19] investigated a more heterogenic population with the AdVance sling and identified prior urethral stricture disease as independent predictor for failure.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Failure of Male Slings and Artificial Urinary Sphincters: Results from a Large Middle European Cohort Study

Hüsch

Kretschmer²,

Thomsen³

et al. 2016

Urol Int

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Introduction: We analysed the impact of predefined risk factors: age, diabetes, history of pelvic irradiation, prior surgery for stress urinary incontinence (SUI), prior urethral stricture, additional procedure during SUI surgery, duration of incontinence, ASA-classification and cause for incontinence on failure and complications in male SUI surgery. Materials and Methods: We retrospectively identified 506 patients with an artificial urinary sphincter (AUS) and 513 patients with a male sling (MS) in a multicenter cohort study. Complication rates were correlated to the risk factors in univariate analysis. Subsequently, a multivariate logistic regression adjusted to the risk factors was performed. A p value <0.05 was considered statistically significant. Results: A history of pelvic irradiation was an independent risk factor for explantation in AUS (p < 0.001) and MS (p = 0.018). Moreover, prior urethral stricture (p = 0.036) and higher ASA-classification (p = 0.039) were positively correlated with explantation in univariate analysis for AUS. Urethral erosion was correlated with prior urethral stricture (p < 0.001) and a history of pelvic irradiation (p < 0.001) in AUS. Furthermore, infection was correlated with additional procedures during SUI surgery in univariate analysis (p = 0.037) in MS. Conclusions: We first identified the correlation of higher ASA-classification and explantation in AUS. Nevertheless, only a few novel risk factors had a significant influence on the failure of MS or AUS.

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Efficacy and Complications of the Adjustable Sling System ArgusT for Male Incontinence: Results of a Prospective 2-Center Study

Cited by 42 publications

References 14 publications

Argus-T Adjustable Male Sling: The Influence of Surgical Technique on Complications and Short-Term Efficacy

Argus-T Adjustable Male Sling: The Influence of Surgical Technique on Complications and Short-Term Efficacy

Targeting Moderate and Severe Male Stress Urinary Incontinence With Adjustable Male Slings and the Perineal Artificial Urinary Sphincter: Focus on Perioperative Complications and Device Explantations

Risk Factors for Failure of Male Slings and Artificial Urinary Sphincters: Results from a Large Middle European Cohort Study

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