Mid‐term outcomes of a male retro‐urethral, transobturator synthetic sling for treatment of post‐prostatectomy incontinence: Impact of radiotherapy and storage dysfunction

Habashy, David; Losco, Giuseppe; Tse, Vincent; Collins, Ruth; Chan, Lewis

doi:10.1002/nau.23078

Cited by 31 publications

(25 citation statements)

References 15 publications

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“…The majority of previous studies assess the success of the AdVance sling using improvement in daily pad use and quality of life questionnaires . Recently, two small Australian series have reported on the outcomes of the AdVance sling . Habashy et al .…”

Section: Discussionmentioning

confidence: 99%

“…10,11,14 Recently, two small Australian series have reported on the outcomes of the AdVance sling. 15,16 Habashy et al reviewed 50 patients with mild or moderate incontinence treated with the AdVance sling at a median (range) follow-up time of 36 (14-72) months and reported that men were using an average of 1.02 PPD, 1.84 PPD less in comparison to before their procedure. They also reported an increasing mean PPD usage with time.…”

Section: Discussionmentioning

confidence: 99%

“…The ICIQ-SF is a validated questionnaire for assessing the severity of urinary incontinence that has good correlation with 24-h pad weights. Scores may be divided into the following three severity categories: mild (1-5), moderate (6-12) and severe (13)(14)(15)(16)(17)(18)(19)(20)(21). 12 The PGI-I is a validated questionnaire to evaluate the quality of life of patients with urinary incontinence.…”

Section: Methodsmentioning

confidence: 99%

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AdVance male urethral sling: medium‐term results in an Australian cohort

Papachristos

Mann²,

Talbot³

et al. 2017

ANZ Journal of Surgery

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Background Since 2008, the AdVance male urethral sling has emerged as a minimally invasive option for stress urinary incontinence. We aimed to evaluate the success of the AdVance sling using validated continence outcome measures. Methods A total of 72 patients treated with the AdVance sling completed validated questionnaires reporting on quality of life and functional outcomes. Incontinence was assessed according to pad weight, pad usage per day (PPD), International Consultation on Incontinence Questionnaire scores and Patient Global Impression of Improvement scores. Results At a median 52‐month follow‐up, 37 (51%) patients were pad free or used a security pad; 18 (25%) used ≥50% fewer PPDs; and the remaining 17 (24%) patients were classified as ‘failed’. According to pad weights, 27 (38%) patients were dry; 32 (44%) had mild incontinence (<100 mL/day); and 13 (18%) had moderate (100–400 mL/day) or severe (>400 mL/day) incontinence. Patient satisfaction was high, with 57 (79%) very much or much better, six (8%) somewhat better and only nine (13%) unchanged or worse. There was a trend of declining continence over time, although the majority remained improved. Patients with severe preoperative incontinence performed significantly worse postoperatively (P = 0.02), as did those who had had prior pelvic radiotherapy (P = 0.02). Conclusions The AdVance sling offers a high rate of success for the treatment of mild to moderate post‐prostatectomy incontinence according to PPD; however, when using objective measures of continence, the success rates are lower. The improvement in urinary control is largely durable over the medium term; however, they may decline beyond 4 years. Reduced efficacy is seen in those with a history of radiotherapy and severe incontinence, although the majority of these men are still improved with surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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AdVance male urethral sling: medium‐term results in an Australian cohort

Papachristos

Mann²,

Talbot³

et al. 2017

ANZ Journal of Surgery

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“…Men with DO appear to have worse continence outcomes after a retroluminal transobturator (AdVance ® ) sling surgery (36-38). Conversely, the presence of DO does not seem to worsen the continence outcome post AUS surgery (27,28).…”

Section: Post Pr Detrusor Overactivitymentioning

confidence: 99%

“…Habashy et al reported on 20 patients with PC who had the AdVance ® sling, and PC is not predictive of worse continence outcome. However, they did not report on the post-sling incidence of renal failure or hydronephrosis (36). …”

Section: Post Prostatectomy Impaired Bladder Compliancementioning

confidence: 99%

Impact of bladder dysfunction in the management of post radical prostatectomy stress urinary incontinence—a review

Hennessey

Hoag

Gani

2017

Transl. Androl. Urol.

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Bladder dysfunction is a relatively common urodynamic finding post radical prostatectomy (RP). It can be the sole cause of post prostatectomy incontinence (PPI) or may be found in association with stress urinary incontinence (SUI). The aim of this review is to provide a comprehensive review of the diagnosis and different treatments of post RP bladder dysfunction. A comprehensive literature review using medical search engines was performed. The search included a combination of the following terms, PPI, detrusor overactivity (DO), detrusor underactivity (DU), impaired compliance, anticholinergic, onabotulinumtoxinA (Botox®) and sacral neuromodulation (SNM). Definitions, general overview and management options were extracted from the relevant medical literature. DO, DU and impaired compliance are common and may occur alone or in combination with SUI. In some patients the conditions exist pre RP, in others they arise due to denervation and surgical changes. DO can be treated with anticholinergics, Botox® and SNM. DO may need to be treated before SUI surgery. DU may be a contraindication to male sling surgery as some patients may go into urinary retention. Severely impaired bladder compliance may be a contraindication to SUI surgery as the upper tracts may be at risk. Each individual dysfunction may affect the outcome of PPI treatments and clinicians should be alert to managing bladder dysfunction in PPI patients.

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