2008 Annual Meeting Abstracts
AdVance Male Sling in Patients With Moderate to Severe Stress Urinary Incontinence
Jennifer L Bepple*, Timothy O Davies*, Kurt A McCammon
Eastern Virginia Medical School, Norfolk, VA
Introduction:
Although the artificial urinary sphincter (AUS) is the gold standard for the treatment SUI in men, many refuse or are not candidates. For these patients treatment options are few, either pelvic therapy, injectables or a sling procedure. We present our experience in men with moderate to severe incontinence who elected to have an AdVance trans-obturator sling.
Methods:
Data was collected on 27 patients with moderate to severe incontinence that elected to undergo an AdVance sling. Preoperatively, all patients underwent urodynamics and cystoscopy. Baseline and post-operative pad usage as well as quality of life (QOL) questionnaires were collected.
Results:
The etiology of the SUI was prostatectomy in 24 pts., cryotherapy, photo-vaporization and TURP in 1 pt each. Follow-up ranged from 4 to 19 months with a mean of 11.6 months. Mean pre-operative pad usage was 6.3 pads, ranging from 5 to 12. 16 patients were wearing < 1PPD post-operatively. The average number of pads used post-operative is 1.5 (2 tailed T-Test, p < 0.0001). 2 patients experienced no improvement. The other 9 patients were at least >50% improved. QOL questionnaires show a significant improvement. There were no erosions, infections or patients in long term retention.
Conclusions: In men with moderate to severe SUI who refuse or are not candidates for an AUS, the AdVance sling can be performed with excellent results in 90% of patients. The durability of the AdVance sling needs to be confirmed with longer follow-up, but short term results appear very encouraging.
