Outpatient Perineal Sling in Adolescent Boys With Neurogenic Incontinence

Abstract

Our retrospective study suggests that the male urethral sling may be an outpatient option for neurogenic incontinence secondary to sphincteric incompetence. Long-term followup in our initial 6 patients shows encouraging durability. Continued study is required to determine strategies that might decrease the complication rate of this approach.

Outcomes of Male Sling Mesh Kit Placement in Patients with Neuropathic Stress Urinary Incontinence: A Single Institution Experience

“…Despite this tension our cure results are lower than in PPI patients, which is similar to previously published data for both InVance and AdVance male slings in neuropathic patients [15,16] . Most of our patients' failures like in other studies [15,16] , are secondary failures due to detrusor dysfunction such as low compliance or NDO.…”

“…This may lead to an increased risk of perineal wound breakdown and a higher infection rate. The issue has also been noted in neuropathic patients after AUS placement [5] as well as in previously described small series with the InVance male sling in neuropathic patients [15] . Based on this data, we recommend that our patients try and decrease pressure on their wound by increasing the number of pressure releases when in the wheelchair and, if possible, decrease the actual time they spend in their wheelchair during the first few months after surgery.…”

“…We did not observe the need for sling explantation due to wound breakdown and sling infection in our AdVance male sling patients, which is similar to earlier published experience with AdVance male sling in neuropathic patients [16] . No patients in our and previously published series [15,16] underwent sling explantation due to urethral erosion although the sling was placed at a bit of higher tension on the urethra than usually recommended in PPI patients. Despite this tension our cure results are lower than in PPI patients, which is similar to previously published data for both InVance and AdVance male slings in neuropathic patients [15,16] .…”

“…No patients in our and previously published series [15,16] underwent sling explantation due to urethral erosion although the sling was placed at a bit of higher tension on the urethra than usually recommended in PPI patients. Despite this tension our cure results are lower than in PPI patients, which is similar to previously published data for both InVance and AdVance male slings in neuropathic patients [15,16] . Most of our patients' failures like in other studies [15,16] , are secondary failures due to detrusor dysfunction such as low compliance or NDO.…”

“…There is limited experience in using mesh male slings in neuropathic patients [15,16] . In this report we represent our institution experience with mesh male sling placement in neuropathic patients.…”