Complications of the AdVance Transobturator Male Sling in the Treatment of Male Stress Urinary Incontinence

Bauer, Ricarda M.; Mayer, Marcel; Maÿ, F.; Gratzke, Christian; Büchner, Alexander; Soljanik, Irina; Bastian, Patrick J.; Stief, Christian G.; Gozzi, Christian

doi:10.1016/j.urology.2009.12.012

Cited by 105 publications

(68 citation statements)

References 18 publications

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“…However, they oc-cur frequently and consist of postoperative perineal pain and urinary retention. In contrast to recently published studies comprising 13 patients with PPI and AdVance® sling implantation and urinary retention rate of 15% (5) and a larger study evaluating complications after AdVance® sling implantation with a retention rate of 21.3% (19), the postoperative urinary retention rate in the present series (34.6 %) is substantially higher. Maybe surgical manipulation and consecutive swelling of the urethral mucosa might contribute to the temporary retention.…”

Section: Discussioncontrasting

confidence: 99%

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: 99%

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 articles showed the success rate of primary male sling placement to be 56-90 % [21][22][23][24]. A large series of 230 patients with SUI who underwent AdVance sling placement showed an overall complication rate of 23.9 %, with urinary retention being the most common complication (21.3 %) [10]. In a multicenter prospective study by Rehder et al [25], AdVance sling had a 76.8 % The mean follow-up period was 24.7 ± 11.8 months in the Argus group and 29.8 ± 14.9 months in the AUS group.…”

Section: Discussionmentioning

confidence: 99%

“…It can serve as a quality metric that may allow surgeons to identify areas of potential improvement in their practice. Data regarding male slings and AUS implantation complications have typically come from retrospectively reviewed large single-institution cases series [10,11] and identified from administrative billing data that have inherent limitations [12].…”

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confidence: 99%

Comparison of complication rates related to male urethral slings and artificial urinary sphincters for urinary incontinence: national multi-institutional analysis of ACS-NSQIP database

et al. 2016

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3.0 %, p < 0.001). Patients with higher BMI were more likely to have a complication, while age, race and Charlson comorbidity index were not associated with higher or lower complication rates. Conclusions Complications rates for both male sling and AUS are low. Male sling is associated with a lower rate of complications than AUS. These findings allow for better patient perioperative counseling regarding 30-day perioperative complications.

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“…25 To date, only 5 severe complications (persistent retention, wound infection, osteitis pubis, sling placed through urethra and urethral erosion) requiring removal or revision have been reported. [26][27][28] The limitations of this study include its retrospective nature, lack of exact pad weights, heterogeneous followup, and lack of standardized quality of life improvement questionnaire. Given the significant side effect profile of the AUS and the fact that a trial of the male sling does not preclude AUS insertion, a prospective, randomized trial is unlikely to receive ethics approval.…”

Section: Discussionmentioning

confidence: 99%

Stemming the tide of mild to moderate post-prostatectomy incontinence: A retrospective comparison of transobturator male slings and the artificial urinary sphincter

Hoy

Rourke

2014

CUAJ

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Introduction: The AUS remains the gold standard treatment for post-prostatectomy incontinence (PPI), although most patients with mild-moderate PPI prefer a sling without strong evidence of procedural equivalence. This study compares outcomes of 2 procedures for the treatment of mild-moderate PPI. Methods: A retrospective review of 124 patients (76 transobturator sling, 48 AUS) with mild-moderate PPI requiring intervention over an 8-year period. The primary outcome was continence. Secondary outcomes included global patient satisfaction, improvement, and complication rates. Mild to moderate incontinence was defined as requiring ≤5 pads/day. Results: There was no significant difference in age (66.2 vs. 68.1 years; p = 0.17) or prostate cancer characteristics for slings and AUS, respectively. AUS patients had higher Charlson comorbidity scores and were more likely to have previous radiotherapy. Median length of follow up was 24 months for slings and 42 months for AUS. There was no difference in continence rates, 88.2% vs. 87.5% (p = 0.79), rate of improvement, 94.7% vs. 95.8% (p = 1.00), or patient satisfaction, 93.4% vs. 91.7% (p = 0.73), for slings and AUS, respectively. Complication rates were equivalent (19.7% vs. 16.7%; p = 1.00), though a significantly higher proportion of complications with AUS were Clavien Grade 3 (0% vs. 75%; p = 0.006). Conclusions: For mild to moderate PPI there is no difference in continence, satisfaction, or improvement rates, between AUS and slings. AUS complications tend to be more severe. Our study supports the use of slings as first-line treatment for mild-moderate PPI.

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Complications of the AdVance Transobturator Male Sling in the Treatment of Male Stress Urinary Incontinence

Cited by 105 publications

References 18 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

Comparison of complication rates related to male urethral slings and artificial urinary sphincters for urinary incontinence: national multi-institutional analysis of ACS-NSQIP database

Stemming the tide of mild to moderate post-prostatectomy incontinence: A retrospective comparison of transobturator male slings and the artificial urinary sphincter

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