The ‘ventral urethral elevation plus’ sling: a novel approach to treating stress urinary incontinence in men

Comiter, Craig V.; Rhee, Eugene

doi:10.1111/j.1464-410x.2007.07277.x

Cited by 19 publications

(13 citation statements)

References 29 publications

(27 reference statements)

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“…A 24-month update from that group revealed a patient satisfaction rate of 70% and a 74% improvement in leakage at a median of 24 months. 115 Transobturator slings have recently been introduced, 37,116,117 which rely more on rotation of the dorsal surface of the proximal bulbous urethra and indirect support of the sphincteric urethra, rather than direct compression of the urethral lumen. 118 Small numbers of patients, with limited follow-up do not allow for adequate assessment of this new technique.…”

Section: Surgical and Minimally Invasive Treatmentsmentioning

confidence: 99%

Surgical treatment of stress incontinence in men

Herschorn

Bruschini

Comiter

et al. 2009

Neurourology and Urodynamics

176

137

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Aims:The committee was charged with the responsibility of reviewing and evaluating all published data relating to surgical treatment of male urinary incontinence since the previous consultation in 2004. Methods: Articles from peer-reviewed journals, abstracts from scientific meetings, and literature searches by hand and electronically formed the basis of this review. The articles were evaluated using Levels of Evidences adapted by the ICUD from the Oxford Centre for Evidence Based Medicine. The Recommendations for Care were based on the level of evidence and discussed among the committee members to reach consensus. The incontinence problems were classified according to their etiology, that is, either primarily sphincter or bladder related. Results: Specialist evaluation of the patient is primarily a clinical approach with history, frequency-volume chart, physical examination, and postvoid residual urine. Other investigations such as radiographic imaging of the lower urinary tract, cystoscopy, and urodynamic studies can provide important information for the clinician. For stress incontinence of various etiologies the artificial urinary sphincter (AUS) has the longest record of satisfactory results. Consideration must be given to the need for revisions for mechanical breakdown, erosion/infection, and recurrent incontinence, as well as cost. Sling procedures are increasingly being reported to have good outcomes for mild to moderate incontinence. Injectable agents have not shown durable results but newer technologies such as volume-adjustable balloons have shown favorable early results. Incontinence following cystectomy with neobladder and pelvic trauma has been treated most commonly with the AUS. Conclusions: Although the literature is replete with well-done cohort studies, there is a need for prospective randomized clinical trials. Recommendations for trials include standardized workup and outcome measures and complete reporting of adverse events and long-term results. Further research is also needed to elucidate the mechanism of post-prostatectomy incontinence.

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Section: Surgical and Minimally Invasive Treatmentsmentioning

confidence: 99%

Surgical treatment of stress incontinence in men

Herschorn

Bruschini

Comiter

et al. 2009

Neurourology and Urodynamics

176

137

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“…The membranous urethral length increased from a mean of 3 mm (range, 0-7 mm) to 17.2 mm (range, 10-22 mm) after tape placement. The mean urethral closure pressure improved from 13.2 cm (range, [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] cm H 2 O to 86.5 (range, 70-100) cm H 2 O. Pre-and postoperative maximum fl ow rates did not differ signifi cantly. Complications included perineal discomfort and tape migration.…”

Section: Male Stress Urinary Incontinencementioning

confidence: 90%

Biomaterials in the treatment of pelvic organ prolapse and stress urinary incontinence: An update

Togami¹,

Krlin²,

Dmochowski³

et al. 2008

Curr Bladder Dysfunct Rep

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Pelvic reconstructive surgeons use biomaterials in many surgical techniques for various indications. Synthetic meshes and biologic grafts have been incorporated in the surgical treatment of pelvic organ prolapse. These materials are also used to correct stress urinary incontinence in men and women. In women, suburethral slings are placed via a number of techniques (retropubic, transobturator) to provide support and facilitate urethral coaptation. In men, support is achieved through mechanical compression and membranous urethra elongation. Recent innovations include a transobturator sling for male stress urinary incontinence, suburethral mini slings for female stress incontinence, and transvaginal mesh to treat pelvic organ prolapse. However, available data on newer techniques are short-term and lack prospective studies and case reports are beginning to emerge describing rare, though serious, complications unique to these newer techniques.

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“…This quadratic ventral elevation urethral sling consists of monofilament polypropylene mesh with four mesh arms, two (inside-out) transobturator arms and two (outside-in) prepubic arms. While the proposed mechanisms of action include ventral urethral elevation from the transobturator arms and distal urethral compression from the prepubic arms (36), the reality is this quadratic sling works similarly to the InVance sling mechanism of action i.e., direct urethral compression against pubic bone. The initial outcome from Virtue sling placement was associated with significant procedure failure and complication rate (37).…”

Section: Methodsmentioning

confidence: 99%

Contemporary surgical devices for male stress urinary incontinence: a review of technological advances in current continence surgery

Chung¹

2017

Transl. Androl. Urol.

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Male stress urinary incontinence (SUI) remains a debilitating condition that adversely impacts all domains of quality of life and is associated with significant social stigma and health economic burden. The incidence of post-prostatectomy urinary incontinence (PPI) depends on the definition of urinary incontinence and the length of patient follow up. In patients with persistent PPI following failure of conservative measures, surgical treatment is recommended although there is no published guideline on when surgery should be performed, and what the best surgical option is. Male slings (MS) can be divided into adjustable or non-adjustable types, and offers an attractive option for patients who wish to avoid mechanical handling during urinary voiding. Published intermediate data supports good safety and efficacy rate in men with mild to moderate degree of SUI. The AMS 800 artificial urinary sphincter (AUS) remains the standard of treatment for complete continence and has the longest efficacy and safety records. Other AUS-like devices are designed to address current AMS 800 limitations but themselves are fraught with their own issues.

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The ‘ventral urethral elevation plus’ sling: a novel approach to treating stress urinary incontinence in men

Cited by 19 publications

References 29 publications

Surgical treatment of stress incontinence in men

Surgical treatment of stress incontinence in men

Biomaterials in the treatment of pelvic organ prolapse and stress urinary incontinence: An update

Contemporary surgical devices for male stress urinary incontinence: a review of technological advances in current continence surgery

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