Mid‐term evaluation of the transobturator male sling for post‐prostatectomy incontinence: focus on prognostic factors

Cornu, Jean‐Nicolas; Sèbe, Philippe; Ciofu, C.; Peyrat, L.; Cussenot, Olivier; Haab, F.

doi:10.1111/j.1464-410x.2010.09765.x

Cited by 149 publications

(129 citation statements)

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“…In accordance with the present data; Cornu, recently presented durable results after a mean follow-up of 21 months, confirming that the AdVance® sling is an efficient treatment option also in the mid-term. The mentioned study showed slightly lower success rates than the present study (no improvement in 22 vs. 11.5% of patients), but interestingly, Cornu also found a trend for an association with previous radiation therapy and treatment failure (16). Bauer and coworkers as well demonstrated a high success rate of the AdVance® sling of 51.6% cured and 23.8% improved patients after thelve months.…”

Section: Discussioncontrasting

confidence: 50%

Single institution experience with the transobturator sling suspension system AdVance® in the treatment of male urinary incontinence: mid-term results

et al. 2011

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Purpose: To evaluate the clinical outcome after placement of AdVance® sling in men with stress urinary incontinence after prostate surgery. Materials and Methods: Incontinence was assessed on basis of number of pad usage. Patients´ satisfaction was evaluated using a non-validated patient questionnaire at 12 months post-operatively. Results: Incontinence cure rate (no pad usage) was 61.5% (16/26) and improvement (1-2 pads per day) was seen in 26.9% (7/26). No improvement was observed in 11.5% (3/26) of patients. A total of 87.5% (21/24) of patients were very satisfied with the operation 22 months after surgery. Success rate in patients with prior radiation therapy (20% cure; 40% improvement) was significantly worse. Conclusions: Placement of the AdVance® sling represents an effective and safe treatment option for patients with post prostate surgery incontinence. Patients that underwent radiotherapy after prostate surgery had lower success rate.

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Section: Discussioncontrasting

confidence: 50%

Single institution experience with the transobturator sling suspension system AdVance® in the treatment of male urinary incontinence: mid-term results

et al. 2011

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“…Several studies have evaluated outcomes after AdVance implantation, and, currently, data up to a maximum follow-up of 39 months are available [12][13][14][15][16][17][18]. The AdVanceXP was marketed in 2010 and its innovations aim to improve both surgical implantation and postoperative stability.…”

Section: Discussionmentioning

confidence: 99%

Mid‐term outcomes after AdVanceXP male sling implantation

et al. 2016

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ObjectiveTo describe efficacy and safety of the AdVanceXP (Boston Scientific, Marlborough, MA, USA) retrourethral transobturator male sling after a mean follow‐up of almost 3 years.Patients and MethodsA total of 41 patients underwent AdVanceXP implantation between July 2010 and March 2012 by a single surgeon. Patients were prospectively evaluated at baseline, after a mean follow‐up of 12months and after an individual maximum follow‐up. Efficacy was evaluated by daily pad usage, 24‐h pad testing, and validated questionnaires (International Consultation on Incontinence questionnaire [ICIQ]). Patient satisfaction was determined using the Patient's Global Impression of Improvement score; quality of life was evaluated using the International Quality of Life (IQOL) score. Patients needing 0 or 1 safety pad with a daily urine loss <8 g were classified as cured. To assess the changes in outcome over time, a Wilcoxon signed‐rank test was used. A P value <0.05 was taken to indicate statistical significance.ResultsThe mean ± sd follow‐up was 33.1 ± 8.1 months. A total of four patients (9.8%) were lost to follow‐up. At follow‐up, 56.1% of patients used 0 or 1 dry safety pad, 17.1% used 1 pad, and 17.1% used 2 pads. Mean pad use was 0.6 pads per day (P < 0.001 vs baseline) with a mean urine loss of 14 g per day. After nearly 3 years, 46.3% of the patients could be classified as cured and 29.3% could be classified as improved. When comparing respective outcomes after 1 and 3 years, no significant changes in mean daily pad use (0.8 at 1 year; P = 1.000), in ICIQ score (5.0 at 3 years vs 5.2 at 1 year; P = 0.500), or in IQOL score (89.2 at 3 years vs 86.8 at 1 year; P = 0.500) were observed. Patients lost less urine based on 24‐h pad testing after nearly 3 years (14 g at 3 years vs 28 g at 1 year; P = 0.106). Subgroup analyses showed no significant differences in efficacy in patients who had previously received radiotherapy or in patients with mild preoperative incontinence. Between 1 and 3 years postoperatively, no complications were detected.ConclusionsThe present study had the longest follow‐up for AdVanceXP to date and is the first to show a high efficacy even after a mean follow‐up of almost 3 years. The results indicate that late‐onset complications are rare after AdVanceXP implantation.

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“…To date, no influence of patients' age on the outcome and complication rates could be identified in MS [14,18,19] or AUS [7] . In this regard, our results are consistent with the present literature of AUS and MS.…”

Section: Discussionmentioning

confidence: 99%

“…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. Further research has to evaluate under which conditions stricture disease may compromise the continence outcome of MS.…”

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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Mid‐term evaluation of the transobturator male sling for post‐prostatectomy incontinence: focus on prognostic factors

Cited by 149 publications

References 14 publications

Single institution experience with the transobturator sling suspension system AdVance® in the treatment of male urinary incontinence: mid-term results

Single institution experience with the transobturator sling suspension system AdVance® in the treatment of male urinary incontinence: mid-term results

Mid‐term outcomes after AdVanceXP male sling implantation

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

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