Skip to main content

Advertisement

SpringerLink
Log in

The bone-anchor sub-urethral sling for the treatment of iatrogenic male incontinence: subjective and objective assessment after 41 months of mean follow-up

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate retrospectively the objective and subjective parameters in 42 male patients who underwent bone anchored sub-urethral sling positioning (BAUS) for SUI (stress urinary incontinence) due to ISD (intrinsic sphincter deficiency).

Methods

Patients with SUI due to radical retropubic prostatectomy (36 patients), transurethral resection of prostate (5 patients) and open simple prostatectomy (1 patient) underwent BAUS positioning between July 1999 and September 2005 (mean FU = 41 months). Before and after surgery, the patients were evaluated by physical examination, urethrocystoscopy, urodynamics, 1 h pad test and QoL questionnaire. Surgical technique involved perineal implantation to the pubic rami using four anchors of a sub-urethral sling made of synthetic (26 patients), biological (4 patients) or mixed (12 patients) material. Patients were stratified into three groups: (1) Cured: dry patients at stress test, pad weight 0–1 g. (2) Improved: patients with mild-moderate incontinence, pad weight 2–50 g. (3) Failed: unchanged patients, pad weight > 50 g.

Results

At the final follow-up visit cured, improved and failed patients were 26 (62%), 4 (8%) and 12 (30%), respectively. Mean pad weight significantly decreased from 104.6 to 47.3 g (55%) and mean total questionnaire score significantly increased to 50.7 (66%). Mean ALPP significantly increased to 50.4 cmH2O (44.8%). Better results were seen with synthetic slings. Main complications were perineal pain (76%), detrusor overactivity (12%) and sling infection (4.8%).

Conclusions

BAUS implantation is a safe, effective, minimally invasive option for iatrogenic male incontinence due to ISD. It compares favourably with AUS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Geary ES, Dendinger TE, Freiha FS, Stamey TA (1995) Incontinence and vesical neck strictures following radical retropubic prostatectomy. Urology 45:1000–1006

    Article  PubMed  CAS  Google Scholar 

  2. Kundu SD, Roehl KA, Eggener SE, Antenor JA, Han M, Catalona WJ (2004) Potency, continence and complications in 3477 consecutive radical retropubic prostatectomies. J Urol 172:2227–2231

    Article  PubMed  Google Scholar 

  3. Gomha MA, Boone TB (2003) Voiding patterns in patients with post prostatectomy incontinence: urodinamic and demographic analisys. J Urol 168:1766–1768

    Article  Google Scholar 

  4. Poore RE, McCullough DL, Jarow JP (1998) Puboprostatic ligament sparing improves urinary continence after radical retropubic prostatectomy. Urology 51:67–72

    Article  PubMed  CAS  Google Scholar 

  5. Braslis KG, Petsch M, Lim A, Civantos F, Soloway MS (1995) Bladder neck preservation following radical prostatectomy: continence and margins. Eur Urol 28:202–208

    PubMed  CAS  Google Scholar 

  6. Cambio AJ, Evans CP (2006) Minimising postoperative incontinence following radical prostatectomy: considerations and evidence. Eur Urol 50:903–913

    Article  PubMed  Google Scholar 

  7. Walsh PC, Marschke P, Ricker D, Burnett AL (2000) Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology 55:58–60

    Article  PubMed  CAS  Google Scholar 

  8. Litwin MS, Hays RD, Fink A, Ganz PA, Leake B, Leach GE, Brook RH (1995) Quality-of-life outcomes in men treated for localized prostate cancer. JAMA 273:129–131

    Article  PubMed  CAS  Google Scholar 

  9. Filocamo MT, Li Marzi V, Del Popolo G, Cecconi F, Marzocco M, Tosto A, Nicita G (2005) Effectiveness of early pelvic floor rehabilitation treatment for post-prostatectomy incontinence. Eur Urol 48:734–738

    Article  PubMed  Google Scholar 

  10. Hunter KF, Moore KN, Cody DJ, Glazener CM (2004) Conservative management for postprostatectomy urinary incontinence. Cochrane Database Syst Rev 2:1843–1845

    Google Scholar 

  11. Filocamo MT, Li Marzi V, Del Popolo G, Cecconi F, Villari D, Marzocco M, Nicita G (2006) Pharmacologic treatment in postprostatectomy stress urinary incontinence. Eur Urol 15:1850–1852

    Google Scholar 

  12. Schlenker B, Gratzke C, Reich O, Schorsch I, Seitz M, Stief CG (2006) Preliminary results on the off-label use of duloxetine for the treatment of stress incontinence after radical prostatectomy or cystectomy. Eur Urol 49:1075–1078

    Article  PubMed  CAS  Google Scholar 

  13. Clemens JQ, Schuster TG, Konnak JW, McGuire EG, Faerber GJ (2001) Revision rate after artificial urinary sphincter implantation for incontinence after radical prostatectomy: actuarial analisys. J Urol 166:1372–1374

    Article  PubMed  CAS  Google Scholar 

  14. Schneider T, Sperling H, Rossi R (2005) Do early injections of bulking agents following radical prostatectomy improve early continence? World J Urol 23:338–342

    Article  PubMed  CAS  Google Scholar 

  15. Madjar S, Raz S, Gousse AE (2001) Fixed and dynamic urethral compression for the treatment of post-prostatectomy urinary incontinence: is history repeating itself? J Urol 166:411–415

    Article  PubMed  CAS  Google Scholar 

  16. Ullrich NFE, Comiter CV (2004) The male sling for stress urinary incontinence: 24-months follow-up with questionnaire based assessment. J Urol 172:207–209

    Article  PubMed  Google Scholar 

  17. Madjar S, Jacoby K, Giberti C, Wald M, Halachmi S, Issaq E, Moskovitz B, Beyar M, Nativ O (2001) Bone anchored sling for the treatment of post-prostatectomy incontinence. J Urol 165:72–76

    Article  PubMed  CAS  Google Scholar 

  18. Abrams P, Cardozo L, Fall M (2002) The standardization of terminology of lower urinary tract function: report from the Standardization Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178

    Article  PubMed  Google Scholar 

  19. Wagner TH, Patrick DL, Bavendam TG (1996) Quality of life in persons with urinary incontinence: development of a new measure. Urology 47:67–72

    Article  PubMed  CAS  Google Scholar 

  20. Agresti A (ed) (1990) Categorical data analysis. Wiley, New York, pp 59–66

    Google Scholar 

  21. Grise P, Thurman S (2002) Urinary incontinence following treatment of localized prostate cancer. Cancer Control 8:532–539

    Google Scholar 

  22. Bosch JL, Klijn AJ, Schroder FH, Hop WC (2000) The artificial urinary sphincter in 86 patients with intrinsic sphincter deficiency: satisfactory actuarial adequate function rates. Eur Urol 38:156–160

    Article  PubMed  CAS  Google Scholar 

  23. Gousse AE, Madjar S, Lambert MM, Fishman IJ (2001) Artificial urinary sphincter for post radical prostatectomy urinary incontinence: long term subjective results. J Urol 166:1755–1757

    Article  PubMed  CAS  Google Scholar 

  24. Cespedes RD (2000) Collagen injection of artificial sphincter for postprostatectomy incontinence: collagen. Urology 55:5–6

    Article  PubMed  CAS  Google Scholar 

  25. Mizuo T, Tanizawa A, Yamada T, Ando M, Oshima H (1992) Sling operation for male stress incontinence by utilizing modified Stamey technique. Urology 39:211–214

    Article  PubMed  CAS  Google Scholar 

  26. Stern JA, Clemens JQ, Tiplitsky SI, Matschke HM, Jain PM, Schaeffer AJ (2005) Long term results of the bulbourethral sling procedure. J Urol 173:1654–1656

    Article  PubMed  Google Scholar 

  27. Comiter CV (2005) The male perineal sling: intermidiate-term results. Neurourol Urodyn 24:648–653

    Article  PubMed  Google Scholar 

  28. Clemens JQ, Bushman W, Schaeffer AJ (1999) Urodynamic analysis of the bulbourethral sling procedure. J Urol 162:1977–82

    Article  PubMed  CAS  Google Scholar 

  29. Dikranian AH, Chang JH, Rhee EY, Aboseif SR (2004) The male perineal sling: comparison of sling materials. J Urol 172:608–610

    Article  PubMed  CAS  Google Scholar 

  30. Hakim J, Gignac M (2004) Erosion of a male polypropylene sling. J Urol 172:1925–1926

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Urology, San Paolo Hospital, Via Genova, 38, 17100, Savona, Italy

    Claudio Giberti, Fabrizio Gallo, Maurizio Schenone & Pierluigi Cortese

Authors
  1. Claudio Giberti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fabrizio Gallo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maurizio Schenone
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pierluigi Cortese
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fabrizio Gallo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Giberti, C., Gallo, F., Schenone, M. et al. The bone-anchor sub-urethral sling for the treatment of iatrogenic male incontinence: subjective and objective assessment after 41 months of mean follow-up. World J Urol 26, 173–178 (2008). https://doi.org/10.1007/s00345-007-0222-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-007-0222-3

Keywords

Search

Navigation