World Journal of Urology

, Volume 37, Issue 3, pp 545–551 | Cite as

Clinical results of a dorsally positioned hydraulic ID-sling in male patients with post-prostatectomy-incontinence

  • Sabina Sevcenco
  • Peter Nyirady
  • Attila Majoros
  • Lukas Lusuardi
  • Hans-Christoph KlinglerEmail author
Original Article



To prospectively evaluate the effectiveness and safety of and the long-term experience with a re-adjustable hydraulic sling (ID-sling) device positioned dorsally to the urethra for the treatment of male post-prostatectomy incontinence (PPI).

Materials and methods

Between September 2007 and November 2009 13 patients with persisting SUI were treated consecutively with an ID-sling™ in two European tertiary centers by a single surgeon. Physical examinations and standardized questionnaires (ICIQ-SF + VAS), pad tests, and 24-h pad number counts were performed at baseline and during follow-up.


The implantation of the hydraulic cuff was uncomplicated in all cases. The ICIQ-SF score diminished from a preoperative mean value of 18 to a mean of five postoperatively. One patient remained completely dry with normal micturition. All patients demonstrated a mild improvement at primary filling but did not show any significant improvement after the second or any subsequent filling. In total, 1/13 (7.7%) patients were completely dry and 5/13 (38.4%) showed improved continence. In 6/13 (46.2%) patients, satisfactory continence results according to subjective criteria, were not achieved. Subsequently, artificial urinary sphincter (AUS) implantation was offered to one patient (7.7%) after 12 months and to ten patients (76,9%) after 24 months.


The implantation of a dorsally placed hydraulic sling is a not yet standardized and complex procedure, even for the experienced surgeon. To date, this implantation method is not an alternative to other devices. An improved sling design is necessary to simplify the surgical procedure and to improve long-term stability.


Male stress urinary incontinence Radical prostatectomy Adjustable male hydraulic urethral sling 


  1. 1.
    Olsson LE, Salomon L, Nadu A et al (2001) Prospective patient-reported continence after laparoscopic radical prostatectomy. Urology 58:570–572CrossRefGoogle Scholar
  2. 2.
    Cooperberg MR, Master VA, Carroll PR (2003) Health related quality of life significance of single pad urinary incontinence following radical prostatectomy. J Urol 170:512–515CrossRefGoogle Scholar
  3. 3.
    Caremel R, Corcos J (2014) Incontinence after radical prostatectomy: anything new in its management? Can Urol Assoc J 8:202–212CrossRefGoogle Scholar
  4. 4.
    Trigo Rocha F, Gomes CM, Mitre AI, Arap S, Srougi M (2008) A prospective study evaluating the efficacy of the artificial sphincter AMS 800 for the treatment of postradical prostatectomy urinary incontinence and the correlation between preoperative urodynamic and surgical outcomes. Urology 71:85–89CrossRefGoogle Scholar
  5. 5.
    Wilson LC, Gilling PJ (2011) Post-prostatectomy urinary incontinence: a review of surgical treatment options. BJU Int 107(Suppl 3):7–10CrossRefGoogle Scholar
  6. 6.
    Scott FB, Bradley WE, Timm GW (1974) Treatment of urinary incontinence by an implantable prosthetic urinary sphincter. J Urol 112:75–80CrossRefGoogle Scholar
  7. 7.
    Bauer RM, Gozzi C, Hubner W, Nitti VW, Novara G (2011) Contemporary management of postprostatectomy incontinence. Eur Urol 59:985–996CrossRefGoogle Scholar
  8. 8.
    Kretschmer A, Hübner W, Sandhu JS, Bauer RM (2016) Evaluation and management of postprostatectomy incontinence: a systematic review of current literature. Eur Urol Focus 2(3):245–259CrossRefGoogle Scholar
  9. 9.
    Kretschmer A, Nitti V (2017) Surgical treatment of male postprostatectomy incontinence: current concepts. Eur Urol Focus 3(4–5):364–376CrossRefGoogle Scholar
  10. 10.
    Bauer RM, Bastian PJ, Gozzi C, Stief CG (2009) Postprostatectomy incontinence: all about diagnosis and management. Eur Urol 55:322–333CrossRefGoogle Scholar
  11. 11.
    Margreiter M, Farr A, Sharma V, Schauer I, Klingler HC (2013) Urethral buttressing in patients undergoing artificial urinary sphincter surgery. J Urol 189:1777–1781CrossRefGoogle Scholar
  12. 12.
    Lucas MG, Bosch RJ, Burkhard FC, Cruz F, Madden TB (2012) European Association of Urology, EAU guidelines on surgical treatment of urinary incontinence. Eur Urol 62:1118–1129CrossRefGoogle Scholar
  13. 13.
    Hubner WA, Gallistl H, Rutkowski M, Huber ER (2011) Adjustable bulbourethral male sling: experience after 101 cases of moderate-to-severe male stress urinary incontinence. BJU Int 107:777–782CrossRefGoogle Scholar
  14. 14.
    James MH, McCammon KA (2014) Artificial urinary sphincter for post-prostatectomy incontinence: a review. Int J Urol 21:536–543CrossRefGoogle Scholar
  15. 15.
    Elliott DS, Barrett DM (1998) Mayo clinic long-term analysis of the functional durability of the AMS 800 artificial urinary sphincter: a review of 323 cases. J Urol 159:1206–1208CrossRefGoogle Scholar
  16. 16.
    Kim SP, Sarmast Z, Daignault S, Faerber GJ, McGuire EJ (2008) Long-term durability and functional outcomes among patients with artificial urinary sphincters: a 10-year retrospective review from the University of Michigan. J Urol 179:1912–1916CrossRefGoogle Scholar
  17. 17.
    Kumar A, Litt ER, Ballert KN, Nitti VW (2009) Artificial urinary sphincter versus male sling for post-prostatectomy incontinence—what do patients choose? J Urol 181:1231–1235CrossRefGoogle Scholar
  18. 18.
    Welk BK, Herschorn S (2012) The male sling for post-prostatectomy urinary incontinence: a review of contemporary sling designs and outcomes. BJU Int 109:328–344CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Sabina Sevcenco
    • 1
  • Peter Nyirady
    • 2
  • Attila Majoros
    • 2
  • Lukas Lusuardi
    • 3
  • Hans-Christoph Klingler
    • 4
    • 5
    Email author
  1. 1.Department of UrologyDonauspitalViennaAustria
  2. 2.Department of UrologySemmelweis University BudapestBudapestHungary
  3. 3.Department of UrologyParacelsus Medical UniversitySalzburgAustria
  4. 4.Department of Urology and Pediatric UrologyWilhelminenspitalViennaAustria
  5. 5.Department of UrologyMedical University of ViennaViennaAustria

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