Male Stress Urinary Incontinence: A Review of Surgical Treatment Options and Outcomes

Abstract

Introduction and Objective. Iatrogenic male stress urinary incontinence (SUI) affects a percentage of men undergoing urologic procedures with a significant impact on quality of life. The treatment of male SUI has evolved significantly with multiple current options for treatment available. The current paper discusses preoperative evaluation of male SUI, available surgical options with reported outcomes, and postoperative complication management. Methods. A pubMed review of available literature was performed and summarized on articles reporting outcomes of placement of the artificial urinary sphincter (AUS) or male slings including the bone anchored sling (BAS), retrourethral transobturator sling (RTS), adjustable retropubic sling (ARS), and quadratic sling. Results. Reported rates of success (variably defined) for BAS, RTS, ARS, and AUS are 36–67%, 9–79%, 13–100%, and 59–91% respectively. Complications reported include infection, erosion, retention, explantation, and transient pain. Male slings are more commonly performed in cases of low-to-moderate SUI with decreasing success with higher degrees of preoperative incontinence. Conclusions. An increasing number of options continue to be developed for the management of male SUI. While the AUS remains the gold-standard therapy for SUI, male sling placement is a proven viable alternative therapy for low-to-moderate SUI.

Therapeutic Efficacy of a New Procedure for Male Urinary Incontinence Combining a Suburethral Polypropylene Mesh and Cardiovascular Patch

“…Three principal slings have been reported in the literature for patients with PPI, including the BAS, RTS, and ARS [4]. BAS involve the use of a synthetic or organic mesh that is tightly fixed to the bilateral inferior pubic ramus with screws or sutures to support and compress the bulbous urethra.…”

“…ARS have a success rate of 72%–79% with a follow-up duration of 26–45 months. The mesh erosion rate was found to be 3%–13% and the infection rate was reported to be 3%–11% in recent reports, with both complications leading to explantation [4,10]. …”

“…We developed a novel suburethral sling procedure for treating male SUI. In this study, we report the long-term outcomes at a mean of over 3 years of follow-up of 31 incontinent men who underwent the suburethral sling procedure [4]. …”

Antrojo pošlaplinio raiščio implantavimas gydant pasikartojusį vyrų šlapimo nelaikymą po nesėkmingos pirmojo raiščio operacijos (klinikinis atvejis)

“…Įklotų skaičius per parą 3 3 0 Liekamasis šlapimas ml (ultragarsu) 0 0 0 Uroflometrija maksimalus tūrinis šlapinimosi greitis Qmax (ml/s) 15 16 20 ICIQ-SF klausimynas (įvertinimas balais) 16 16 0…”

“…nesėkmingų atvejų po "Argus®" raiščio implantavimo užgaktiniu būdu [3,4,5,6,7,8]. Literatūroje dar nėra pateiktų rekomendacijų, kaip gydyti vyrus esant tebesitęsančiam ar atsinaujinusiam šlapimo nelaikymui po pirmojo raiščio implantavimo [10,11,12,13,14,15,16,17]. Dauguma autorių aprašo gerus dirbtinio sfinkterio implantavimo rezultatus po nesėkmingo raiščio pritaikymo operacijos [18,19].…”