MP33-10 THE ADVANCEXP MALE SLING: RESULTS OF A PROSPECTIVE MULTICENTER STUDY

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence Therapy I1 Apr 2014MP33-10 THE ADVANCEXP MALE SLING: RESULTS OF A PROSPECTIVE MULTICENTER STUDY Ricarda Bauer, Roland Homberg, Peter Gebhartl, Benedikt Klehr, Peter Rehder, Florian May, Alexander Kretschmer, Christian Stief, and Christian Gozzi Ricarda BauerRicarda Bauer More articles by this author , Roland HombergRoland Homberg More articles by this author , Peter GebhartlPeter Gebhartl More articles by this author , Benedikt KlehrBenedikt Klehr More articles by this author , Peter RehderPeter Rehder More articles by this author , Florian MayFlorian May More articles by this author , Alexander KretschmerAlexander Kretschmer More articles by this author , Christian StiefChristian Stief More articles by this author , and Christian GozziChristian Gozzi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.961AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In recent years, several studies showed the effectiveness and safety of the AdVance sling for the treatment of male stress urinary incontinence (SUI). In end of 2010 the second generation of Advance, the AdVanceXP was introduced. Aim of the study was to evaluate the efficacy and safety of the AdVanceXP sling in male SUI in a prospective multicenter study. METHODS 55 patients were included. Patients with urine loss while lying, previous incontinence surgery and a coaptive zone <1cm were excluded. Postoperatively, a standardized 24-hour-padtest, quality of life scores (IQOL and ICIQ-UI SF), VAS for pain, IIEF5, IPSS and PGI-score were performed. All patients with 0-5g in the padtest were defined as cured and improved with a reduction of urine loss >50%. RESULTS Mean urine loss in the padtest was 379g (median 302g). After a follow-up of 3 months 69.1% of the patients were cured. Mean urine loss decreased significantly to 42g (p<.001). Mean I-QoL and ICIQ-UI SF improved significantly (both p<.001). Mean VAS was 1 and mean PGI 1.5. After a follow-up of 6 months (n= 42) 78.6% of the patients were cured. Mean urine loss decreased significantly to 20g (p<.001). mean I-QoL and ICIQ-UI SF improved significantly (both p<.001). Mean VAS was 0.7 and mean PGI 1.5. After a follow-up of 12 months (n= 28) 67.7% of the patients were cured. Mean urine loss decreased significantly to 16.4g (p<.001). mean I-QoL and ICIQ-UI SF improved significantly (both p<.001). Mean VAS was 0.4 and mean PGI 1.4. There were no significant changes in IIEF5 and IPSS at 3, 6 or 12 months follow-up. No intraoperative complications occurred. In 3 patients (5.5%) persistent urinary retention/residual urine occurred due to overtensioning of the sling during removal of the Tyvek liners. In these patients one sling arm was dissected. After dissection all patients were able to empty the bladder completely and without negative change of the continence status. Therefore, the implantation technique was subsequently changed so that a Mersilene tape is placed around both sling arms before tensioning in order to fix the sling arms in position during removal of the Tyvek liners. These changes resulted in no further cases of persistent urinary retention. No erosion occured. No explantation was necessary. 2 patients had UTIs with fever and were treated with antibiotics. 3 patients needed for a few days oral pain medications. CONCLUSIONS The AdVanceXP shows good effectiveness and low complication rates in a follow-up of up to 1 year. However overtensioning of the sling especially during removal of the Tyvek liners resulting in persistent urinary retention is possible. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e342 Advertisement Copyright & Permissions© 2014Metrics Author Information Ricarda Bauer More articles by this author Roland Homberg More articles by this author Peter Gebhartl More articles by this author Benedikt Klehr More articles by this author Peter Rehder More articles by this author Florian May More articles by this author Alexander Kretschmer More articles by this author Christian Stief More articles by this author Christian Gozzi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...