The AdVance male sling as a minimally invasive treatment for intrinsic sphincter deficiency in patients with neurogenic bladder sphincter dysfunction: A pilot study

Groen, Luitzen Albert; Spinoit, Anne‐Françoise; Laecke, Erik Van; Troyer, Bart De; Everaert, Karel

doi:10.1002/nau.21256

Cited by 32 publications

(21 citation statements)

References 17 publications

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“…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.…”

Section: Discussionsupporting

confidence: 90%

“…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] .…”

Section: Discussionsupporting

confidence: 90%

“…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.…”

Section: Discussionmentioning

confidence: 74%

“…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.…”

Section: Background and Objectivesmentioning

confidence: 99%

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

2015

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Background and Objectives: The mainstay of therapy in patients with neuropathic stress urinary incontinence (nSUI) has been through the use of artificial urinary sphincter (AUS). AUS infection/erosion rates are higher in nSUI patients and these patients tend to be younger, increasing the likelihood of multiple AUS revisions in the future. We review our experience with mesh male slings for patients with nSUI. Methods: A retrospective review of patients who had mesh sling placement. Results: Twenty patients were identified between 2003 and 2011. 14/20 (70%) (5 = AdVance, 8 = InVance, 1 = Virtue) were available for long-term evaluation; in 6/20 (30%) the sling was removed for either infection or perineal wound breakdown. The mean time from injury to male sling was 148.2 (29-449) months. Pre-/post-op fluorourodynamic study was performed in 13 and 7 patients, respectively. There were no significant differences in ALPP (46.4 vs. 55.7 cm H₂O, p = 0.106) and MCC (456.6 vs. 608 ml, p = 0.21) in the 7 patients who had a post-op study: five patients had new onset low bladder compliance and two had new onset detrusor overactivity post-sling. With a mean follow-up of 24.7 (1-66) months, 4/14 (28.6%) had no UI. Conclusions: With short-term follow-up, mesh male slings are a feasible option to treat nSUI. There appears to be a lower success rate for UI resolution, which may be attributable to new onset detrusor failure or wound infection requiring sling removal.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 74%

Section: Background and Objectivesmentioning

confidence: 99%

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

2015

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“…Synthetic tapes are up-to-date rarely investigated in male neurological patients. Currently, only one small study presents promising data from a mixed adult and pediatric male neurological population treated with the AdVance sling [84]. RCT and data on long-term follow-up are lacking.…”

Section: Suspension Therapymentioning

confidence: 99%

The management of urinary incontinence in the male neurological patient

Mehnert

Kessler

2014

Current Opinion in Urology

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PURPOSE OF REVIEW: Urinary incontinence in male neurological patients is a very frequent problem but treatment remains challenging. Thus, we summarize and highlight the latest developments in the management of urinary incontinence in this specific patient population. RECENT FINDINGS: Intermittent self-catheterization, antimuscarinics, intradetrusor injections with onabotulinumtoxinA, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter are the cornerstones of the armamentarium for treating neurogenic urinary incontinence. However, with the exception of onabotulinumtoxinA intradetrusor injections, level of evidence is often low and male-specific outcomes are virtually not available. Alternative conservative and/or minimally invasive procedures such as neuromodulation techniques and suburethral suspension devices provide promising data with apparently good safety and tolerability but still insufficient evidence lacking randomized control trials. SUMMARY: Standard options for treatment of urinary incontinence in neurological patients remain largely unchanged. Alternative treatment options, especially of conservative or minimally invasive character, have the potential to further broaden the therapeutic spectrum. While a higher level of evidence is needed to assess the potential of such therapeutic approaches, randomized controlled trials in the male neurological population present a challenge. To truly advance treatment of urinary continence in male neurological patients, well-designed, multicenter studies are warranted. Purpose of review Urinary incontinence in male neurological patients is a very frequent problem but treatment remains challenging. Thus, we summarize and highlight the latest developments in the management of urinary incontinence in this specific patient population. Recent findingsIntermittent self-catheterization, antimuscarinics, intradetrusor injections with onabotulinumtoxinA, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter are the cornerstones of the armamentarium for treating neurogenic urinary incontinence. However, with the exception of onabotulinumtoxinA intradetrusor injections, level of evidence is often low and male-specific outcomes are virtually not available. Alternative conservative and/or minimally invasive procedures such as neuromodulation techniques and suburethral suspension devices provide promising data with apparently good safety and tolerability but still insufficient evidence lacking randomized control trials. SummaryStandard options for treatment of urinary incontinence in neurological patients remain largely unchanged. Alternative treatment options, especially of conservative or minimally invasive character, have the potential to further broaden the therapeutic spectrum. While a higher level of evidence is needed to assess the potential of such therapeutic approaches, randomized controlled trials in the male neurological population present a challenge. To truly advance treatment of urinary continence in mal...

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Surgical treatment of neurogenic stress urinary incontinence: A systematic review of quality assessment and surgical outcomes

Farag

Koens

Sievert

et al. 2014

Neurourology and Urodynamics

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The AdVance male sling as a minimally invasive treatment for intrinsic sphincter deficiency in patients with neurogenic bladder sphincter dysfunction: A pilot study

Abstract: Implantation of the AdVance male sling is feasible in both adult and pediatric patients. A promising cure/improvement rate was achieved as well as a low complication rate.

Cited by 32 publications

References 17 publications

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

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

The management of urinary incontinence in the male neurological patient

Surgical treatment of neurogenic stress urinary incontinence: A systematic review of quality assessment and surgical outcomes

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