Evaluation of Salvage Male Transobturator Sling Placement Following Recurrent Stress Urinary Incontinence After Failed Transobturator Sling

Martinez, Edward J.; Zuckerman, Jack M.; Henderson, Katherine D.; Edwards, Brooke; McCammon, Kurt

doi:10.1016/j.urology.2014.10.016

Cited by 22 publications

(14 citation statements)

References 14 publications

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“…Martinez et al examined a cohort of 18 patients who had persistent PPSUI after transobturator sling placement and who underwent excision and replacement of the sling. 9 In this study 28.9% of patients were completely dry and 55.6% reported 1 or less than 1 pad per day at a median followup of 12.6 months (range 6 to 52) while in 28% salvage therapy failed and a tertiary continence procedure was done. 9 Solijanik et al reported on placement of a new transobturator sling without excision of the failed one.…”

Section: Discussionmentioning

confidence: 57%

“…9 In this study 28.9% of patients were completely dry and 55.6% reported 1 or less than 1 pad per day at a median followup of 12.6 months (range 6 to 52) while in 28% salvage therapy failed and a tertiary continence procedure was done. 9 Solijanik et al reported on placement of a new transobturator sling without excision of the failed one. 13 They found a 46% continence rate (no pad use) at 6 months among 33 patients with 30% reporting 1 security pad per day and 12.1% reporting treatment failure.…”

Section: Discussionmentioning

confidence: 57%

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The Artificial Urinary Sphincter is Superior to a Secondary Transobturator Male Sling in Cases of a Primary Sling Failure

et al. 2015

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In this cohort of patients with post-prostatectomy stress urinary incontinence and a failed primary sling those who underwent a secondary sling procedure were up to 6 times more likely to have persistent incontinence vs those who underwent artificial urinary sphincter placement. These data are useful for counseling patients and planning surgery. We currently recommend placement of an artificial urinary sphincter for patients in whom an initial sling has failed.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 57%

The Artificial Urinary Sphincter is Superior to a Secondary Transobturator Male Sling in Cases of a Primary Sling Failure

et al. 2015

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“…Repeat slings are successful in some patients, and an increased success rate has been reported in patients who present with recurrent incontinence further out from their initial MUS. 16,17 On the other hand, outcomes associated with primary AUS placement after prior MUS in the setting of recurrent or persistent incontinence after initial sling placement has been the subject of few studies. 18,19 Ajay and colleagues performed a retrospective analysis comparing outcomes in patients undergoing AUS vs. repeat sling after prior failed MUS.…”

Section: Discussionmentioning

confidence: 99%

“…Several small published series have reported improvements, such as pad reduction and higher quality of life scores, with a repeat sling procedure, and late incontinence recurrence after the primary sling seems to correlate with improved outcomes. 16,17 However, many patients who desire surgical management of their SUI after failed sling, especially in those with early-onset incontinence or other risk factors for sling failure, may benefit from AUS placement in lieu of a repeat sling procedure.…”

Section: Introductionmentioning

confidence: 99%

The impact of prior urethral sling on artificial urinary sphincter outcomes

Ziegelmann

Linder

Rivera

et al. 2016

CUAJ

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Introduction: We sought to evaluate device outcomes in men who underwent primary artificial urinary sphincter (AUS) placement after failed male urethral sling (MUS). Methods: We performed a retrospective chart review of 990 men who underwent an AUS procedure between 2003 and 2014. Of these, 540 were primary AUS placements, including 30 (5.5%) with a history of MUS. AUS revisions and explantations were compared between men stratified by the presence of prior sling. Hazard ratios (HR) adjusting for competing risks were used to determine the association with prior sling and AUS outcomes (infection/ erosion, urethral atrophy, and mechanical malfunction), while overall device failure was estimated using Kaplan-Meier and Coxregression analysis. Results: There was no significant difference in age, body mass index, prior prostatectomy, or pelvic radiation when stratified by history of MUS. However, patients with a history of MUS were more likely to have undergone prior collagen injection (p=0.01). On univariate and multivariate analysis, prior MUS was not associated with device failure (HR 1.54; p=0.27). Three-year overall device survival did not significantly differ between those with and without prior MUS (70% vs. 85%; p=0.21). Also, there were no significant differences in the incidence of device infection/erosion, mechanical malfunction, and urethral atrophy. Conclusions: AUS remains a viable treatment option for men with persistent or recurrent stress urinary incontinence after MUS. However, while not statistically significant, we identified a trend towards lower three-year device outcomes in patients with prior urethral sling. These findings indicate the need for longer-term studies to determine if slings pose an increased hazard.

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“…The role of Advance sling as salvage continence surgery following recurrence of SUI with failed transobturator sling showed an overall success rate of 56%, and 39% of patients were dry after 17.5 months of follow-up (33). Failure of AdVance sling can also be salvaged with AUS or prostate adjustable continence therapy (34).…”

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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Evaluation of Salvage Male Transobturator Sling Placement Following Recurrent Stress Urinary Incontinence After Failed Transobturator Sling

Cited by 22 publications

References 14 publications

The Artificial Urinary Sphincter is Superior to a Secondary Transobturator Male Sling in Cases of a Primary Sling Failure

The Artificial Urinary Sphincter is Superior to a Secondary Transobturator Male Sling in Cases of a Primary Sling Failure

The impact of prior urethral sling on artificial urinary sphincter outcomes

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

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