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KMID : 1240020160200040335
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International Neurourology Journal
2016 Volume.20 No. 4 p.335 ~ p.341
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Long-term Outcome of the Retrourethral Transobturator Male Sling After Transurethral Resection of the Prostate
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Alexander Kretschmer
Alexander Buchner
Benedikt Leitl
Markus Grabbert
Anne Sommer
Christian G. Stief
Wael Khoder
Christian Gozzi
Ricarda M. Bauer
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Abstract
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Purpose : To evaluate long-term outcomes of AdVance and AdVanceXP male slings in patients with persistent stress urinary incontinence (SUI) after transurethral resection of the prostate (TURP).
Methods : A total of 18 consecutive patients received AdVance (n=14) or AdVanceXP (n=4) male sling implantation between 2007 and 2013. Continence was determined by pad use, 24-hour pad testing and validated questionnaires (International Consultation on Incontinence Questionnaire Short Form, ICIQ-SF). Quality of life was evaluated by International Quality of Life (IQoL) score. Patient satisfaction was measured with patient’s global impression of improvement score. Cure was defined as 0?5 g in the 24-hour pad test. Statistical analysis included Fisher exact and Wilcoxon test (P<0.05).
Results : Follow-up was available for 15 patients who underwent further analysis. After a median follow-up of 70 months (range, 18?83 months), mean daily pad usage was 1.8±2.1 pads (P=0.015 vs. baseline level). Mean IQoL score was 66.4±31.6 (P=0.050 vs. baseline level), and mean ICIQ-SF score was 9.5±6.6 (P=0.077 vs. baseline level). Based on 24-hour pad testing, mean daily urine loss was 31.2±64.5 g (median, 0 g; range, 0?209 g). Cure rate was 46.7%, and cure-and-improved rate was 60.0%. Assessing predictive features for success, better results were found in patients who needed up to 4 pads preoperatively (P=0.041) as well as for patients ≤71 years at the time of implantation (P=0.041).
Conclusions : The findings indicate that AdVance and AdVanceXP implantation can be performed effectively and safely in men suffering from SUI after TURP. However, long-term success rates seem to be lower compared to SUI after radical prostatectomy and patients should be counseled accordingly.
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KEYWORD
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Urinary Stress, Incontinence, Suburethral Slings, Transurethral Resection of the Prostate, Complications
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