Long-term Functional Outcomes and Patient Satisfaction After AdVance and AdVanceXP Male Sling Surgery

Favero, Lina Del; Tasso, Giovanni; Deruyver, Yves; Tutolo, Manuela; Beels, E.; Schillebeeckx, Charlotte; Ridder, Dirk De; Aa, Frank Van der

doi:10.1016/j.euf.2022.01.017

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…However, soon caution was later advised in recommending a fixed sling in patients with a history of pelvic irradiation [12]. More recently, severely compromised long-term functional outcomes and patient satisfaction were confirmed [28,29]. The Virtue male quadratic sling is another interesting option, as it provides bidirectional compression and elevation of the bulbous [30]; however, there is no information regarding its use in patients with previous radiation.…”

Section: Discussionmentioning

confidence: 99%

Results of Adjustable Trans-Obturator Male System in Patients with Prostate Cancer Treated with Prostatectomy and Radiotherapy: A Multicenter Study

Angulo,

Téllez,

Giammò

et al. 2023

JCM

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(1) Background: Treatment of male stress incontinence in patients with prostate cancer treated with radical prostatectomy and adjuvant pelvic radiation is a therapeutic challenge. The efficacy and safety of the adjustable trans-obturator male system (ATOMS) in these patients is not well established, despite the general belief that outcomes are worse than in patients without radiation. (2) Methods: Retrospective multicenter study evaluating patients treated with silicone-covered scrotal port (SSP) ATOMS implant after radical prostatectomy and radiotherapy in nine different institutions between 2016 and 2022. The primary endpoint was dry patient rate, defined as pad-test ≤ 20 mL/day. The secondary endpoints were complication rate (defined using Clavien–Dindo classification), device removal and self-perceived satisfaction using the Patient Global Impression of Improvement (PGI-I) scale. Wilcoxon rank-sum test, Fisher’s exact test and logistic regression were performed using stepwise method with a 0.15 entry and 0.1 stay criteria. (3) Results: 223 patients fulfilled the criteria for inclusion and 12 (5.4%) received salvage prostatectomy after radiation and 27 (12.1%) previous devices for stress incontinence. After ATOMS adjustment, 95 patients (42.6%) were dry and 36 (16.1%) had complications of any grade (grade I, n = 20; grade II, n = 11; grade III, n = 5) during the first 3 months postoperatively. At a mean of 36 ± 21 months follow-up, the device was explanted in 26 (11.7%) patients. Regarding self-perceived satisfaction with the implant, 105 of 125 patients (84%) considered themselves satisfied (PGI-I 1 to 3). In the univariate analysis, dryness was associated to younger age (p = 0.06), primary prostatectomy (p = 0.08), no previous incontinence surgery (p = 0.02), absence of overactive bladder symptoms (p = 0.04), absence of bladder neck stricture (p = 0.001), no need of surgical revision (p = 0.008) and lower baseline incontinence severity (p = 0.0003). Multivariate analysis identified absence of surgical revision (p = 0.018), absence of bladder neck stricture (p = 0.05), primary prostatectomy (p = 0.07) and lower baseline incontinence severity (p < 0.0001) were independent predictors of dryness. A logistic regression model was proposed and internally validated. (4) Conclusions: ATOMS is an efficacious and safe alternative to treat male incontinence after radical prostatectomy and adjuvant radiotherapy. Factors predictive of dryness are identified in this complex scenario to allow for better patient selection.

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Section: Discussionmentioning

confidence: 99%

Results of Adjustable Trans-Obturator Male System in Patients with Prostate Cancer Treated with Prostatectomy and Radiotherapy: A Multicenter Study

Angulo,

Téllez,

Giammò

et al. 2023

JCM

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“… 17 Reported cure rates with the definition 0–1 dry pad are 51% at 52 months median FU ( N = 72) and 53% at 36 months FU ( N = 151). 18 , 19 Authors using the definition 0–1 pads 20 have reported a cure rate of 66% at 5 years FU ( N = 172) while those using the definition leakage of up to 5 g/24 h 21 , 22 , 23 , 24 have shown cure rates of 46% to 72% at up to 5 years FU ( N = 15–115).…”

Section: Discussionmentioning

confidence: 99%

AdVance™ male sling for stress urinary incontinence: Long‐term follow‐up and patient satisfaction

Boe,

Nilsen,

Holm

2023

BJUI Compass

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ObjectivesTo evaluate long‐term effects, complications and satisfaction among patients treated with AdVance™ and AdVance™ XP slings (AS) at a Norwegian specialist care hospital.Materials and MethodsPatients who had an AS implanted due to stress urinary incontinence (SUI) 2009–2016 were identified retrospectively. Demographic and perioperative data were extracted from electronic patient files. We did a patient‐reported outcome measure (PROM) survey with the Expanded Prostate Cancer Index Composite (EPIC‐26) urinary domain and a Satisfaction Questionnaire (SQ) 2018–2020. Cure was defined as use of ≤1 pad/day.ResultsThe AS was implanted in 165 patients, mainly due to mild to moderate SUI (median leakage 112 g, range 13–589 g/24 h). Preoperative urodynamics showed mild detrusor overactivity (DO) in 11 patients. At 6‐week follow‐up, 148 patients (90%) were cured. The most common complication was urinary retention (N = 38), transient in 32 patients (range 1–42 days). Two patients were later operated with division of the sling due to persistent retention. During clinical follow‐up of up to 12 years, 27 patients were reoperated due to persistent/recurrent incontinence. The PROM survey was sent to 125 patients and 115 (92%) replied at median 73 (20–134) months postoperatively. Ninety‐one (79%) used ≤1 pads/day, 97 (85%) were satisfied, one patient‐reported pain. Regression analyses showed that failure (>1 pad/day) was significantly associated with a higher amount of leakage preoperatively and at the 6‐week follow‐up. Total cure rate in the complete cohort was 64% at median 73 (20–134) months follow‐up.ConclusionsThe AS shows good and persistent long‐term results in patients with mild to moderate SUI. The only identified risk factor for long‐term failure was higher amount of leakage preoperatively. The incidence of high body mass index (BMI), DO and previous radiotherapy was low and not significantly associated with failure but is still considered risk factors.

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“…In comparative work, there are largely no significant differences between the original and XP models, both in terms of outcomes and complications except for higher rates of urinary retention in the XP (20). Adverse events related to these slings include elevated postvoid residual, increased bleeding, and decreased satisfaction with a need for subsequent incontinence procedures (21).…”

Section: Fixed Msmentioning

confidence: 99%

A narrative review on surgical treatment options for male stress urinary incontinence

Prebay¹,

Foss²,

Wang³

et al. 2023

Transl Androl Urol

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Background and Objective: Stress urinary incontinence (SUI) can occur due to a variety of etiologies.For male patients specifically, SUI is typically thought of as iatrogenic secondary to intrinsic sphincter deficiency occurring after prostate surgery. Given the noted negative impact that SUI can have on a man's quality of life, multiple treatment options have been developed to improve symptoms. However, there is no "One-Size-Fits-All" approach to management of male SUI. In this narrative review, we sought to highlight some of the various procedures and devices available to treat men with bothersome SUI.Methods: This narrative review gathered primary resources through Medline search, and secondary resources by cross-referencing citations used in articles of interest. We started our investigation by searching for previous systematic reviews on male SUI and treatments for male SUI. Furthermore, we reviewed societal guidelines, such as the American Urological Association and Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction guidelines and the recently published European Urological Association guidelines. Our review focused on English-language full-length manuscripts when available.

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Long-term Functional Outcomes and Patient Satisfaction After AdVance and AdVanceXP Male Sling Surgery

Cited by 8 publications

References 16 publications

Results of Adjustable Trans-Obturator Male System in Patients with Prostate Cancer Treated with Prostatectomy and Radiotherapy: A Multicenter Study

Results of Adjustable Trans-Obturator Male System in Patients with Prostate Cancer Treated with Prostatectomy and Radiotherapy: A Multicenter Study

AdVance™ male sling for stress urinary incontinence: Long‐term follow‐up and patient satisfaction

A narrative review on surgical treatment options for male stress urinary incontinence

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