The Virtue Sling—A New Quadratic Sling for Postprostatectomy Incontinence—Results of a Multinational Clinical Trial

Comiter, Craig V.; Rhee, Eugene; Tu, Le-Mai; Herschorn, Sender; Νitti, Victor W.

doi:10.1016/j.urology.2014.02.062

Cited by 60 publications

(53 citation statements)

References 13 publications

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“…With a median RLPP value of 41 cm H 2 O, 13 (43%) patients were completely cured (0 ppd) of their incontinence, with an additional eight (27%) showing improvement of their incontinence, comparable to the patient-reported cure and improvement rates of other male slings in the literature. 8,12 Furthermore, there were only two cases (6%) of transient urinary retention.…”

Section: Discussionmentioning

confidence: 97%

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Retrograde leak point pressure measurement improves outcomes of the Virtue male sling for postprostatectomy incontinence

Sourial

Richard

Morisset

et al. 2017

CUAJ

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Introduction: We aimed to compare the efficacy of two different sling tensioning approaches, and to report our experience, including safety and impact on quality of life (QoL) of the Virtue ® male sling for the treatment of postprostatectomy incontinence (PPI). Methods: From our prospectively maintained database, we retrospectively identified all men treated with the Virtue male sling for PPI between March 2009 and February 2014 by two urologists in two institutions. Baseline demographic data and the sling tensioning method were abstracted from the database. Likewise, the Patient Global Impression of Improvement (PGI-I) scale, severity of incontinence, and clinical outcomes were also abstracted. Results: 48 patients were treated with the Virtue quadratic male sling. Sling tensioning was done using cystoscopy in the first 18 patients (Group 1), while per-operative retrograde leak point pressure (RLPP) measurement was done in the last 30 patients (Group 2). The median (interquartile range [IQR]) followup from the day of surgery was 22 (15-41) months. At the last followup visit, 7 (39%) patients in Group 1 were cured or improved of their PPI, compared to 21 (70%) patients in Group 2 (p=0.03). The final median (IQR) RLPP in these patients was 41 (37-48) cm H 2 O. Transient pain was the most common adverse event, occurring in 23 (48%) of patients. Twenty-one (70%) patients in Group 2 were "much better" or "very much better" with their device, compared to 7 (39%) in Group 1 (p=0.0008). Conclusions:The Virtue male sling is a valuable treatment option for PPI. Per-operative RLPP measurement significantly improves cure and satisfaction rates.

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Section: Discussionmentioning

confidence: 97%

“…Subjective improvement was measured using the the PGI-I score. [11][12][13][14] Secondary objectives were to report the midterm efficacy, safety, and impact on QoL of the Virtue quadratic male sling.…”

Section: Objectivesmentioning

confidence: 99%

Retrograde leak point pressure measurement improves outcomes of the Virtue male sling for postprostatectomy incontinence

Sourial

Richard

Morisset

et al. 2017

CUAJ

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“…Transobturator and prepubic components of the quadratic fixation contributed to increased urethral resistance as measured by intraoperative retrograde leak point pressure (39). In a recently published multinational clinical trial, Virtue “2” sling with fixation method improved the initial success rate of 42.9% to 79.2% in the cohort (40). …”

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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“…2 Slings are less efficacious in men who have received pelvic radiation and, thus, an AUS is preferred in such individuals. Thus, a voiding diary and urodynamic evaluation are imperative.…”

Section: Editorial Commentarymentioning

confidence: 99%

Editorial Commentary

Comiter¹

2014

Urology Practice

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The Virtue Sling—A New Quadratic Sling for Postprostatectomy Incontinence—Results of a Multinational Clinical Trial

Cited by 60 publications

References 13 publications

Retrograde leak point pressure measurement improves outcomes of the Virtue male sling for postprostatectomy incontinence

Retrograde leak point pressure measurement improves outcomes of the Virtue male sling for postprostatectomy incontinence

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

Editorial Commentary

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