515 THREE YEAR FOLLOW-UP OF THE ADVANCE SLING

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence - Evaluation & Therapy I1 Apr 2012515 THREE YEAR FOLLOW-UP OF THE ADVANCE SLING Ricarda Bauer, Peter Rehder, Francois Haab, Christian Gozzi, and Jean-Nicolas Cornu Ricarda BauerRicarda Bauer Munich, Germany More articles by this author , Peter RehderPeter Rehder Innsbruck, Austria More articles by this author , Francois HaabFrancois Haab Paris, France More articles by this author , Christian GozziChristian Gozzi Brixen, Italy More articles by this author , and Jean-Nicolas CornuJean-Nicolas Cornu Paris, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.587AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The AdVance male sling has shown to be efficacious in studies with a follow-up with a maximum of 2 years for post-prostatectomy incontinence (PPI). However, studies with longer follow-up are lacking. Aim of this study was to assess the longer-term clinical outcome, over three years, after AdVance sling implantation for PPI management. METHODS 156 consecutive patients with PPI were included in a multicentre prospective evaluation. The study was performed in three European tertiary reference centers. Preoperative assessment included evaluation of postvoid residual urine (PVR), uroflowmetry, pad usage, one hour pad-test, quality of life scores (IQOL and ICIQ-UI SF), urethrocystoscopy and urodynamics. The AdVance sling was implanted in all patients according to the same operative technique. At 1, 6, 12 and 36 months the following parameters were evaluated: pad usage, one hour pad-test; uroflowmetry, PVR and quality of life scores. Patients were classified as cured if there was no pad use or only one dry pad for security reasons, as improved if pad reduction was > 50%; all others were considered as failures. Complications of surgery and influence of incontinence severity, age, previous surgery for SUI or adjuvant therapy on outcome was assessed. RESULTS Follow-up over three years was available for 149 patients (three died – not related to the AdVance implantation - and four were lost to follow-up). At 3 years, 53% of patients were cured, 24% were improved and 23% failed. In addition, pad usage was significantly reduced compared with baseline (both p<0.0001). In comparison to the one year data, results were stable. Seven patients received a second treatment for SUI (artificial urinary sphincter or re-do sling). Lower success rates were observed in patients with previous surgical treatment for PPI (64.4% vs.78.3%, p=0.04). Age had no negative impact on cure rate. Cure rate seemed higher in patients with mild or moderate incontinence (<5 pads/day) compared with severe incontinence (>5 pads/day) (80.2% vs. 63.6%) but the results were not significant. Quality of life significantly improved. The most common complications were mild perineal post-operative pain (50%), transient urinary retention (14%), mild dysuria (4.5%), perineal hematoma (3.2%). One sling was explanted due to a symphisitis. CONCLUSIONS The AdVance sling is effective and safe in the three year follow up for treating male SUI after prostate surgery. Complications occurred only in the early postoperative period. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e212 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ricarda Bauer Munich, Germany More articles by this author Peter Rehder Innsbruck, Austria More articles by this author Francois Haab Paris, France More articles by this author Christian Gozzi Brixen, Italy More articles by this author Jean-Nicolas Cornu Paris, France More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...