2008 Annual Meeting Abstracts
Urodynamic Changes Following AdVance Male Sling Insertion
Jennifer L Bepple*, Timothy O. Davies*, Kurt A. McCammon
Eastern Virginia Medical School, Norfolk, VA
The AdVance male sling is a treatment option for post-prostatectomy incontinence (PPI), with the goal of eliminating urinary incontinence without affecting voiding parameters. A concern of any procedure in treating men with PPI is whether the treatment induces obstruction and causes retention. We present the urodynamic changes and early results associated with the AdVance male sling.
Data was prospectively collected from 15 consecutive patients undergoing AdVance male sling for PPI. Urodynamics were performed at baseline and repeated at 6 months postoperatively, analyzing valsalva leak point pressure (VLPP), detrusor voiding pressure, post void residual (PVR), maximum and average flow rates. A 24-hour pad test was completed preoperatively and at 6 months.
Median age at the time of the procedure was 63.8 years (44.6-74.7). 2 of the patients did not have urodynamics available and were subsequently excluded from analysis. The mean preoperative and 6-month patient-reported pad usage was 4.52 and 1.04 respectively (2 tailed t test, p=0.0009). The 24-hour pad test performed preoperatively and at 6 months yielded pad weights of 779.3 and 67.6 (p=0.03). The VLPP improved significantly (p=0.032) while the detrusor voiding pressure, PVR, maximum and average flow rates remained relatively unchanged.
These results are encouraging, as this series demonstrates a significant improvement in patient reported pad usage, 24-hour pad tests, and VLPP without signs of obstruction. The improvement in incontinence is accompanied without any changes in the other voiding parameters. Ongoing studies with longer follow-up are pending to compare with these promising early results.