Advertisement

Current Bladder Dysfunction Reports

, Volume 13, Issue 4, pp 244–251 | Cite as

Current Update on Management of Male Stress Urinary Incontinence

  • Lara MacLachlan
  • Arthur Mourtzinos
Stress Incontinence and Prolapse (S Reynolds, Section Editor)
  • 21 Downloads
Part of the following topical collections:
  1. Topical Collection on Stress Incontinence and Prolapse

Abstract

Purpose of Review

Male stress urinary incontinence has significant economic and psychosocial effects on a patient. The following manuscript examines the surgical treatment as well as the recent technological advances in implantable devices for male stress urinary incontinence.

Recent Findings

The number of urethral slings available to the male patient with stress incontinence has increased dramatically over the last several years has increased. Since its introduction, the male transobturator sling has been shown to have particular unique advantages. Data is rapidly becoming available regarding the use of adjustable slings and the AdVanceXP male sling.

Summary

The artificial urinary sphincter remains the standard of care in the index patient with male stress urinary incontinence. Although management of this condition has improved dramatically over the past decade, large well-designed nonrandomized prospective studies are still needed to increase the level of evidence.

Keywords

Male stress urinary incontinence Male urethral sling Artificial urinary sphincter 

Notes

Compliance with Ethical Standards

Conflict of Interest

Dr. MacLachlan declares that she has no conflict of interest.

Dr. Mourtzinos reports that he has received speaker honorarium from Boston Scientific, Astellas, and Medtronic.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: •• Of major Importance

  1. 1.
    Trost L, Elliot DS. Male stress urinary incontinence: a review of surgical treatment options and outcomes. Adv Urol. 2012;2012:287489.CrossRefGoogle Scholar
  2. 2.
    Ficarra V, Novara G, Rosen RC, Artibani W, Carroll PR, Costello A, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robotic-assisted radical prostatectomy. Eur Urol. 2012;62:405–17.CrossRefGoogle Scholar
  3. 3.
    Chen YC, Lin PH, Jou YY, Lin VCH. Surgical treatment for urinary incontinence after prostatectomy: a meta-analysis and systematic review. PLoS One. 2017;12(5):e0130867.CrossRefGoogle Scholar
  4. 4.
    Kumar A, Litt ER, Ballert KN, Nitti VW. Artificial urinary sphincter versus male sling for post-prostatectomy incontinence—what do patients choose? J Urol. 2009;181:1231–5.CrossRefGoogle Scholar
  5. 5.
    Rehder P, Staudacher NM, Schachtner J, et al. Hypothesis that urethral bulb (corpus spongiosum) plays an active role in male urinary continence. Adv Urol. 2016;2016:6054730.CrossRefGoogle Scholar
  6. 6.
    Kretschmer A, Grabbert M, Sommer A, Stief CG, Bauer RM. Mid-term outcomes after AdVanceXP male sling implantation. BJU Int. 2016;118:458–63.CrossRefGoogle Scholar
  7. 7.
    Grise P, Vautherin R, Njinou-Ngninkeu B, Bochereau G, Lienhart J, Saussine C, et al. I-STOP TOMS transobturator male sling, a minimally invasive treatment for post-prostatectomy incontinence: continence improvement and tolerability. Urology. 2012;79:458–63.CrossRefGoogle Scholar
  8. 8.
    Yiou R, Loche CM, Lingombet O, Abbou C, Salomon L, de la Taille A, et al. Evaluation of urinary symptoms in patients with post-prostatectomy urinary incontinence treated with the male sling TOMS. Neurourol Urodyn. 2015;34:12–7.CrossRefGoogle Scholar
  9. 9.
    Bauer RM, Soljanik I, Fullhase C, et al. Results of the AdVance transobturator male sling after radical prostatectomy and adjuvant radiotherapy. Urology. 2011;77:474–9.CrossRefGoogle Scholar
  10. 10.
    Bauer RM, Gozzi C, Klehr B, et al. Impact of the “repositioning test” on postoperative outcome of retroluminar transobturator male sling implantation. Urol Int. 2013;90:334–8.CrossRefGoogle Scholar
  11. 11.
    •• Kretschmer A, Hubner W, Sandhu JS, et al. Evaluation and management of postprostatectomy incontinence: a systematic review of current literature. Eur Urol Focus. 2016;2:245–59. Although there have been several advances in the treatment of male stress urinary incontinence, no randomized controlled trial has yet investigated the outcome of one specific surgical treatment or compared the outcome of different surgical treatment options. CrossRefGoogle Scholar
  12. 12.
    Lucas MG, Bosch RJ, Burkhard FC, Cruz F, Madden TB, Nambiar AK, et al. EAU guidelines on assessment and nonsurgical management of urinary incontinence. Eur Urol. 2012;62:1130–42.CrossRefGoogle Scholar
  13. 13.
    Lima JP, Pompeo AC, Bezerra CA. ArgusT versus AdVance sling for postprostatectomy urinary incontinence: a randomized clinical trial. Int Braz J Urol. 2016;42:531–9.CrossRefGoogle Scholar
  14. 14.
    Chung E, Smith P, Malone G, Cartmill R. Adjustable versus non-adjustable male sling for post-prostatectomy urinary incontinence: a prospective clinical trial comparing patient choice, clinical outcomes and satisfaction rate with a minimum follow up of 24 months. Neurourol Urodyn. 2016;35:482–6.CrossRefGoogle Scholar
  15. 15.
    Kretschmer A, Husch T, Thomsen F, et al. Targeting moderate and severe male stress urinary incontinence with adjustable male slings and the perineal artificial urinary sphincter: focus on perioperative complications and device explantations. Int Neurourol J. 2017;21:109–15.CrossRefGoogle Scholar
  16. 16.
    Romano SV, Huebner W, Rocha FT, Vaz FP, Muller V, Nakamura F. A transobturator adjustable system for male incontinence: 30-month follow-up of a multicenter study. Int Braz J Urol. 2014;40:781–9.CrossRefGoogle Scholar
  17. 17.
    Bauer RM, Rutkowski M, Kretschmer A, Casuscelli J, Stief CG, Huebner W. Efficacy and complications of the adjustable sling system ArgusT for male incontinence: results of a prospective 2 center study. Urology. 2015;85:316–20.CrossRefGoogle Scholar
  18. 18.
    Dalpiaz O, Knopf HJ, Orth S, Griese K, Aboulsorour S, Truss M. Midterm complications after placement of the male adjustable suburethral sling: a single center experience. J Urol. 2011;186:604–9.CrossRefGoogle Scholar
  19. 19.
    Hübner WA, Gallistl H, Rutkowski M, Huber ER. Adjustable bulbourethral male sling: experience after 101 cases of moderate-to-severe male stress urinary incontinence. BJU Int. 2011;107:777–82.CrossRefGoogle Scholar
  20. 20.
    Friedl A, Muhlstadt S, Zachoval R, et al. Long-term outcome of the adjustable transobturator male system (ATOMS): results of a European multicenter study. BJU Int. 2017;119:785–92.CrossRefGoogle Scholar
  21. 21.
    Angulo JC, Arance I, Esquinas C, Dorado JF, Marcelino JP, Martins FE. Outcome measures of adjustable transobturator male system with pre-attached scrotal port for male stress urinary incontinence after radical prostatectomy: a prospective study. Adv Ther. 2017;34:1173–83.CrossRefGoogle Scholar
  22. 22.
    Seweryn J, Bauer W, Ponholzer A, Schramek P. Initial experience and results with a new adjustable transobturator male system for the treatment of stress urinary incontinence. J Urol. 2012;187:956–61.CrossRefGoogle Scholar
  23. 23.
    Hoda MR, Primus G, Fischereder K, von Heyden B, Mohammed N, Schmid N, et al. Early results of a European multicenter experience with a new self-anchoring adjustable transobturator system for treatment of stress urinary incontinence in men. BJU Int. 2013;111:296–303.CrossRefGoogle Scholar
  24. 24.
    Sousa-Escandon A, Cabrera J, Mantovani F, et al. Adjustable suburethral sling (male remeex system) in the treatment of male stress urinary incontinence: a multicenteric European study. Eur Urol. 2007;52:1473–9.CrossRefGoogle Scholar
  25. 25.
    Comiter CV, Rhee EY, Tu LM, Herschorn S, Nitti VW. The virtue sling–a new quadratic sling for postprostatectomy incontinence—results of a multinational clinical trial. Urology. 2014;84:433–8.CrossRefGoogle Scholar
  26. 26.
    Sourial MW, Richard PO, Morisset J, Jundi M, Tu LM. Retrograde leak point pressure measurement improves outcomes of the Virtue male sling for postprostatectomy incontinence. Can Urol Assoc J. 2017;11:E271–6.CrossRefGoogle Scholar
  27. 27.
    Ferro M, Bottero D, D’Elia C, et al. Virtue male sling for post-prostatectomy stress incontinence: a prospective evaluation and mid-term outcomes. BJU Int. 2017;119:482–8.CrossRefGoogle Scholar
  28. 28.
    McCall AN, Rivera ME, Elliott DS. Long-term follow-up of the virtue quadratic male sling. Urology. 2016;93:213–6.CrossRefGoogle Scholar
  29. 29.
    Cornu JN, Sebe P, Ciofu C, et al. The AdVance transobturator male sling for postprostatectomy incontinence: clinical results of a prospective evaluation after a minimum follow-up of 6 months. Eur Urol. 2009;56:923–7.CrossRefGoogle Scholar
  30. 30.
    Bauer RM, Mayer ME, Gratzke C, Soljanik I, Buchner A, Bastian PJ, et al. Prospective evaluation of the functional sling suspension for male postprostatectomy stress urinary incontinence: results after 1 year. Eur Urol. 2009;56:928–33.CrossRefGoogle Scholar
  31. 31.
    Rehder P, Mitterberger MJ, Pichler R, Kerschbaumer A, Glodny B. The 1 year outcome of the transobturator retroluminal repositioning sling in the treatment of male stress urinary incontinence. BJU Int. 2010;106:1668–72.CrossRefGoogle Scholar
  32. 32.
    Bauer RM, Soljanik I, Fullhase C, et al. Mid-term results for the retroluminar transobturator sling suspension for stress urinary incontinence after prostatectomy. BJU Int. 2010;108:94–8.CrossRefGoogle Scholar
  33. 33.
    Cornu JN, Sebe P, Ciofu C, et al. Mid-term evaluation of the transobturator male sling for post-prostatectomy incontinence: focus on prognostic factors. BJU Int. 2010;108:236–40.CrossRefGoogle Scholar
  34. 34.
    Rehder P, Haab F, Cornu JN, et al. Treatment of postprostatectomy male urinary incontinence with the transobturator retruluminal repositioning sling suspension: 3-year follow-up. Eur Urol. 2012;62:40–5.CrossRefGoogle Scholar
  35. 35.
    Zuckerman JM, Edwards B, Henderson K, Beydoun HA, McCammon KA. Extended outcomes in the treatment of male stress urinary incontinence with a transobturator sling. Urology. 2014;83:939–45.CrossRefGoogle Scholar
  36. 36.
    Kowalik CG, DeLong JM, Mourtzinos AP. The AdVance transobturator male sling for post-prostatectomy incontinence: subjective and objective outcomes with 3 years follow up. Neurourol Urodyn. 2015;34:251–4.CrossRefGoogle Scholar
  37. 37.
    Kretschmer A, Grabbert M, Sommer A, Stief CG, Bauer RM. Mid-term outcomes after AdVanceXP male sling implantation. BJU Int. 2016;118:458–63.CrossRefGoogle Scholar
  38. 38.
    Bauer RM, Gozzi C, Klehr B, Kretschmer A, Grabbert M, Rehder P, et al. AdVanceXP male sling: 2-year results of a multicenter study. World J Urol. 2016;34:1025–30.CrossRefGoogle Scholar
  39. 39.
    Bauer RM, Grabbert MT, Klehr B, Gebhartl P, Gozzi C, Homberg R, et al. 36-month data for the AdVanceXP(R) male sling: results of a prospective multicenter study. BJU Int. 2017;119:626–30.CrossRefGoogle Scholar
  40. 40.
    Bochove-Overgaauw DM, Schrier BP. An adjustable sling for the treatment of all degrees of male stress urinary incontinence: retrospective evaluation of efficacy and complications after a minimal follow up of 14 months. J Urol. 2011;185:1363–8.CrossRefGoogle Scholar
  41. 41.
    Dalpiaz O, Knopf HJ, Orth S, Griese K, Aboulsorour S, Truss M. Mid-term complications after placement of the male adjustable suburethral sling: a single center experience. J Urol. 2011;186:604–9.CrossRefGoogle Scholar
  42. 42.
    Hübner WA, Gallistl H, Rutkowski M, Huber ER. Adjustable bulbourethral male sling: experience after 101 cases of moderate-to-severe male stress urinary incontinence. BJU Int. 2011;107:777–82.CrossRefGoogle Scholar
  43. 43.
    Romano SV, Huebner W, Rocha FT, Vaz FP, Muller V, Nakamura F. A transobturator adjustable system for male incontinence: 30-month follow-up of a multicenter study. Int Braz J Urol. 2014;40:781–9.CrossRefGoogle Scholar
  44. 44.
    Bauer RM, Rutkowski M, Kretschmer A, Casuscelli J, Stief CG, Huebner W. Efficacy and complications of the adjustable sling system ArgusT for male incontinence: results of a prospective 2-center study. Urology. 2015;85:316–20.CrossRefGoogle Scholar
  45. 45.
    Kretschmer A, Husch T, Thomsen F, et al. Complications and short-term explantation rate following artificial urinary sphincter implantation: results from a large middle European multi-institutional case series. Urol Int. 2016;97:205–11.CrossRefGoogle Scholar
  46. 46.
    Viers BR, Linder BJ, Rivera ME, Rangel LJ, Ziegelmann MJ, Elliott DS. Long-term quality of life and functional outcomes among primary and secondary artificial urinary sphincter implantations in men with stress urinary incontinence. J Urol. 2016;196:838–43.CrossRefGoogle Scholar
  47. 47.
    Collado Serra A, Dominguez-Escrig J, Gomez-Ferrer A, et al. Prospective follow-up study of artificial urinary sphincter placement preserving the bulbospongiosus muscle. Neurourol Urodyn. 2017;36:1387–94.CrossRefGoogle Scholar
  48. 48.
    Leon P, Chartier-Kastler E, Roupret M, et al. Long-term functional outcomes after artificial urinary sphincter implantation in men with stress urinary incontinence. BJU Int. 2015;115:951–7.CrossRefGoogle Scholar
  49. 49.
    Litwiller SE, Kim KB, Fone PD, deVere White RW, Stone AR. Post-prostatectomy incontinence and the artificial urinary sphincter: a long term study of patient satisfaction and criteria for success. J Urol. 1996;156:1975–80.CrossRefGoogle Scholar
  50. 50.
    Elliott DS, Barrett DM. Mayo clinic long-term analysis of the functional durability of the AMS 800 artificial urinary sphincter: a review of 323 cases. J Urol. 1998;159:1206–8.CrossRefGoogle Scholar
  51. 51.
    Lai HH, Hsu EI, Teh BS, Butler EB, Boone TB. 13 years experience with artificial urinary sphincter implantation at Baylor college of medicine. J Urol. 2007;177:1021–5.CrossRefGoogle Scholar
  52. 52.
    Raj GV, Peterson AC, Toh KL, et al. Outcomes following revisions and secondary implantation of the artificial urinary sphincter. J Urol. 2005;173:1242–5.CrossRefGoogle Scholar
  53. 53.
    •• Biardeau X, Aharony S, AUS Consensus Group et al. Artificial urinary sphincter: report of the 2015 consensus conference. Neurourol Urodyn 2016;35 Suppl 2:S8–24. These guidelines constitute a reference document, which will help urologists to carefully select patients and apply the most adapted management to implantation, follow-up and trouble-shooting of the artificial urinary sphincter. Google Scholar
  54. 54.
    van der Aa F, Drake MJ, Kaysan GR, et al. The artificial urinary sphincter after a quarter of a century: a critical systematic review of its use in male non-neurogenic incontinence. Eur Urol. 2013;63:681–9.CrossRefGoogle Scholar
  55. 55.
    Rodriguez DA, Ascanio EF, Vicens VA et al. Four years experience with the FlowSecure Artificial Urinary Sphincter. Problems and solutions. In: Proceedings of the 41st annual meeting of the International Continence Society; Glasgow, UK; 2011.Google Scholar
  56. 56.
    Schiavini JL, Damiäo R, de Resende Júnior JA, et al. Treatment of post-prostate surgery urinary incontinence with the periurethral constrictor: a retrospective analysis. Urology. 2010;75(6):1488–92.CrossRefGoogle Scholar
  57. 57.
    Staerman F, G-Llorens C, Leon P, Leclerc Y. ZSI 375 artificial urinary sphincter for male urinary incontinence: a preliminary study. BJU Int. 2013;111:E202–6.CrossRefGoogle Scholar
  58. 58.
    Malaeb BS, Elliott SP, Lee J, Anderson DW, Timm GW. Novel artificial urinary sphincter in the canine model: the tape mechanical occlusive device (TMOD). Urology. 2011;77(1):211–6.CrossRefGoogle Scholar
  59. 59.
    Lamraoui H, Bonvilain A, Robain G, et al. Rectus abdominis electromyography and MechanoMyoGraphy comparison for the detection of cough. Conf Proc IEEE Eng Med Biol Soc. 2010;2010:6502–5.PubMedGoogle Scholar
  60. 60.
    Adin CA, Farese JP, Cross AR, Provitola MK, Davidson JS, Jankunas H. Urodynamic effects of a percutaneously controlled static hydraulic urethral sphincter in canine cadavers. Am J Vet Res. 2004;65(3):283–8.CrossRefGoogle Scholar
  61. 61.
    Gregori A, Romanò AL, Scieri F, Pietrantuono F, Incarbone GP, Salvaggio A, et al. Transrectal ultrasound-guided implantation of adjustable continence therapy (ProACT): surgical technique and clinical results after a mean follow-up of 2 years. Eur Urol. 2010;57(3):430–6.CrossRefGoogle Scholar
  62. 62.
    Chung E, Ranaweera M, Cartmill R. Newer and novel artificial urinary sphincters (AUS): the development of alternatives to the current AUS device. BJU Int. 2012;110(Suppl 4):5–11.CrossRefGoogle Scholar
  63. 63.
    Ziegelmann MJ, Linder BJ, Rivera ME, Viers BR, Elliott DS. The impact of prior urethral sling on artificial urinary sphincter outcomes. Can Urol Assoc J. 2016;10:405–9.CrossRefGoogle Scholar
  64. 64.
    Martinez EJ, Zuckerman JM, Henderson K, Edwards B, McCammon K. Evaluation of salvage male transobturator sling placement following recurrent stress urinary incontinence after failed transobturator sling. Urology. 2015;85(2):478–82.CrossRefGoogle Scholar
  65. 65.
    Rubin RS, Xavier KR, Rhee E. Virtue quadratic male sling for stress incontinence-surgical guide for placement and delayed revision. Transl Androl Urol. 2017;6(4):666–73.CrossRefGoogle Scholar
  66. 66.
    Kim PH, Pinheiro LC, Atoria CL, Eastham JA, Sandhu JS, Elkin EB. Trends in the use of incontinence procedures after radical prostatectomy: a population based analysis. J Urol. 2013;189:602–8.CrossRefGoogle Scholar
  67. 67.
    Ajay D, Zhang H, Gupta S, Selph JP, Belsante MJ, Lentz AC, et al. The artificial urinary sphincter is superior to a secondary transobturator male sling in cases of a primary sling failure. J Urol. 2015;194(4):1038–42.CrossRefGoogle Scholar
  68. 68.
    Comiter C. Surgery for postprostatectomy incontinence: which procedure for which patient? Nat Rev Urol. 2015;12:91–9.CrossRefGoogle Scholar
  69. 69.
    Fuller TW, Ristau BT, Benoit RM. Simultaneous cuff revision and placement of an AdVance male sling for persistent post-prostatectomy urinary incontinence initially managed with AMS 800 artificial urinary sphincter. Can J Urol. 2014;5:7507–9.Google Scholar
  70. 70.
    Tuygun C, Imamoglu A, Gucuk A, Goktug G, Demirel F. Comparison of outcomes for adjustable bulbourethral male sling and artificial urinary sphincter after previous artificial urinary sphincter erosion. Urology. 2009;73:1363–7.CrossRefGoogle Scholar
  71. 71.
    Margreiter M, Farr A, Sharma V, Schauer I, Klingler HC. Urethral buttressing in patients undergoing artificial urinary sphincter surgery. J Urol. 2013;189:1777–81.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Urology, Lahey Health and Medical CenterTufts School of MedicineBurlingtonUSA

Personalised recommendations