Abstract
Purpose
To evaluate the efficacy of the Advance® and AdvanceXP® slings in men with stress urinary incontinence (SUI) post-radical prostatectomy and to identify predictive factors for outcome.
Methods
Included were male patients with SUI following radical prostatectomy who had a positive “repositioning test”, 24 h-pad weight (PW) test < 400 g and who were continent at night and at rest. Urgency was defined as a sudden compelling desire to pass urine, which was difficult to defer. The cure rate was defined as no pad use.
Results
From February 2008 to October 2014, 24 AdVance® and 70 AdVance XP® were implanted. The median (range) follow-up was 49 (12–102) months. The overall cure rate was 77%. The preoperative 24 h PW was significantly related to the continence outcome (p = 0.044). A total of 12 patients (13%) presented with postoperative AUR, which was significantly related to abnormal voiding detrusor activity (p = 0.036). Twenty-two patients (23%) had postoperative urgency (16% “de novo”), which was significantly related to preoperative urgency (p = 0.003). During follow-up, a degree of deterioration of continence was observed in five patients who were classed as cured initially. To date, no reports of urethral sling erosion have been made.
Conclusions
The AdVance® and AdVanceXP® slings are safe and effective in relieving SUI following post-radical prostatectomy. There were no differences between the two slings in terms of efficacy, urgency or postoperative AUR. There was a moderate rate of “de novo “urgency and low rate of loss of continence during follow-up.
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Acknowledgements
The authors would like to acknowledge the contributions of Mª del Carmen Rodríguez and Maria Serrano, nurses in the Urology Dept, Fundación IVO, Valencia, Spain.
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ACS and JR-B designed of the research study. ACS and JD-E acquisition of data. ACS and MR-B drafting the manuscript. JD-E and JR-B performed the research. IMOR and ACS analysis and interpretation of the data. CRT and IMOR statistical analysis
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Argimiro Collado Serra: Surgical trainer for AMS-800 and AdVance (Boston Scientific) and Virtue (Coloplast). José Domínguez-Escrig, Isabel María Ortiz Rodríguez, Miguel Ramirez-Backhaus, Carmelo Rodríguez Torreblanca and José Rubio-Briones have declared that they have no conflict of interest
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All applicable international, national and/or institutional guidelines for the care and use of animals were followed.
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Collado, A., Domínguez-Escrig, J., Ortiz Rodríguez, I.M. et al. Functional follow-up after Advance® and Advance XP® male sling surgery: assessment of predictive factors. World J Urol 37, 195–200 (2019). https://doi.org/10.1007/s00345-018-2357-9
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DOI: https://doi.org/10.1007/s00345-018-2357-9