Adjustable versus non-adjustable male sling for post-prostatectomy urinary incontinence: A prospective clinical trial comparing patient choice, clinical outcomes and satisfaction rate with a minimum follow up of 24 months.

Abstract

To review the patient choice, clinical outcomes and satisfaction rate between adjustable and non-adjustable male sling (MS) with a minimum follow up of 24 months. A prospective review of clinical parameters in all male patients who underwent MS surgery between January 2009 and December 2011 was undertaken. Validated instruments were utilized in the follow-up survey. A total of 44 MS were inserted with 25 men choosing adjustable Argus (Promedon, Cordoba, Argentina) and 19 men received non-adjustable AdVance (American Medical Systems, Minnetonka, MN) MS. The mean age and follow-up for men in the Argus group were 65.4 years and 36.2 months, and in AdVance group were 63.8 years and 33.1 months. Revision surgery was performed in six Argus MS for recurrent urinary incontinence. Social continence (defined as 0 to 1 urinary pad use) was achieved in 23 patients (92%) with Argus MS and 16 patients (84%) with AdVance MS (P = 0.45). The overall satisfaction rate on a 5-point scale was 4.5 in Argus and 4.3 in AdVance patients, and there was no significant difference in the PGI-I score between the two groups (P = 0.36). Kaplan-Meier analysis of urinary continence and patient satisfaction rates were not statistically significant between Argus and AdVance slings (P = 0.76 and P = 0.38). Given the choice between the two types of MS, more men chose adjustable Argus over non-adjustable AdVance sling. There was no significant difference in the clinical outcome, social continence and overall patient satisfaction rates between the two types of MS in the short term. Neurourol. Urodynam. 35:482-486, 2016. © 2015 Wiley Periodicals, Inc.