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Efficacy of the bulbourethral autologous sling in treating male stress urinary incontinence: a three-year experience from a single center

  • Urology – Original Paper
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Abstract

Aim

To evaluate the efficacy of the bulbourethral rectus autologous sling in treating male stress urinary incontinence.

Patients and methods

We retrospectively reviewed operative logs from a single surgeon of 32 male patients treated over a 3-year period (March 2001 to March 2004) for stress incontinence by implantation of a bulbourethral free rectus sling. The mean age of the patients was 46.4 (range 14–76); mean follow-up time was 29.5 months (range 24–52). Neurogenic dysfunction was the most common cause of incontinence in this group (17/32 cases; 53.1%). Efficacy was evaluated objectively in terms of the number of pads used per day, subjective patient satisfaction, and morbidity. We also investigated a possible correlation between pre-operative parameters and outcome.

Results

Ten patients (31.3%) were cured (totally dry, 15.6%; the remainder one pad per day), while five (15.6%) patients improved but still required two pads per day. Overall, 15 of 32 patients (46.9%) were satisfied with the outcome of the operation. In total, seven patients presented a mild complication (21.9%). De novo urgency was the most common complication presented in four of 32(11.6%). No case of urethral erosion was encountered. Univariate analysis failed to find any correlation between the final outcome and the following parameters: patient age, duration of incontinence, earlier anti-incontinence surgery, severity of pre-operative incontinence, pre-operative Valsalva leak point pressure, decreased compliance, decreased bladder capacity, and pre-operative evidence of detrusor overactivity.

Conclusions

In conclusion, the free rectus fascia bulbourethral sling is a modestly effective technique for the treatment of male stress incontinence with mild morbidity. The use of this method seems that it is suitable for selected cases.

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Acknowledgments

We thank Dr A. Konstantinopoulos for the statistical analysis of the data.

Disclosure

A. Athanasopoulos is or has been an investigator, lecturer, and consultant for pharmaceutical companies producing or developing drugs for lower urinary tract symptoms (Pfizer,Astellas,Ucb,Lilly,Allergan,Bard,Amgen). E. McGuire: Financial interest and/or other relationship with Pfizer, Novartis, Astellas, Carbon Medical technologies, Pharmacia and Ortho-McNeil.

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Authors and Affiliations

  1. Department of Urology, Medical School, University of Michigan, Ann Arbor, USA

    Anastasios Athanasopoulos & Edward J. McGuire

  2. 38 Papadiamantopoulou Str, 26225, Patras, Greece

    Anastasios Athanasopoulos

Authors
  1. Anastasios Athanasopoulos
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  2. Edward J. McGuire
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Correspondence to Anastasios Athanasopoulos.

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Athanasopoulos, A., McGuire, E.J. Efficacy of the bulbourethral autologous sling in treating male stress urinary incontinence: a three-year experience from a single center. Int Urol Nephrol 42, 921–927 (2010). https://doi.org/10.1007/s11255-010-9742-7

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  • DOI: https://doi.org/10.1007/s11255-010-9742-7

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