To evaluate the efficacy and safety of the AdVance XP male sling in a midterm follow-up for the treatment of male urinary incontinence in a selected patient cohort.
In all, 115 patients with postprostatectomy incontinence were prospectively enrolled. A previous endoscopic evaluation of a sufficient coaptive zone in the repositioning test was mandatory. Patients with urine leakage in supine position or previous incontinence surgery were excluded. Postoperatively a standardized 24-hour pad test and pad usage were evaluated. To compare pre- and postoperative continence status nonparametric t test was used. A P-value of <.05 was seen as statistically significant.
Median preoperative urine loss in the 24-hour pad test was 272 g (min. 42-max. 1600) and was significantly improved at any point in follow-up. Success was defined as 0 pads per day and a maximum of 5 g in the 24-hour pad test. After a follow-up of 48 months, 71.7% of the patients were cured, whereas 15.0% of patients had an improved continence situation and 13.3% were classified as failed. Mean urine loss decreased significantly to 24.4 g (P ≤ .001). No severe intra- or postoperative complications are to be reported. Median follow-up was 4.2 years.
A stable effectiveness in a selected patient cohort can also be demonstrated in an extended follow-up. The complication rates are low and no late postoperative complications occurred, indicating the safety of the procedure.
Neurourology and urodynamics. 2019 Jul 11 [Epub ahead of print]
Markus Grabbert, Jan-Niclas Mumm, Benedikt Klehr, Alexander Kretschmer, Peter Gebhartl, Christian Gozzi, Roland Homberg, Florian May, Peter Rehder, Christian G Stief, Ricarda M Bauer
Department of Urology, University Hospital Freiburg, Freiburg, Germany., Department of Urology, University of Munich (LMU), Munich, Germany., Department of Urology, Salzkammergut Klinikum Voecklabruck, Voecklabruck, Austria., Department of Urology, Marienklinik, Bolzano, Italy., Department of Urology, St. Barbara Hospital Hamm, Hamm, Germany., Department of Urology, Helios Amper Hospital Dachau, Dachau, Germany., Department of Urology, University Hospital Innsbruck, Innsbruck, Austria.