Facteurs prédictifs d’échec de cure d’incontinence urinaire d’effort masculine par bandelette sous-urétrale à ancrage osseux type InVance™ : étude multicentrique du comité des troubles mictionnels de l’homme de l’Association française d’urologie

Abstract

To define predictive factors of treatment failure in a multicentric study for the treatment of stress male urinary incontinence by InVance (American Medical System, USA) bone anchored sub-urethral sling. Cases treated by InVance between January 2005 and December 2007 in four French academic centers were collected. Eighty-four patients were evaluated. Mean age was 68 years old. With a mean follow-up of 20 months, 38 patients (45%) were dry, 22 (26%) were improved, and 24 (29%) suffered treatment failure. In univariate analysis, three parameters were significantly associated with treatment failure, including severe urinary incontinence (P=0.005), urodynamic instability (P=0.043), and incontinence due to a bitherapy including external radiotherapy (P=0.031). If zero or one versus two or three risk factors were present, treatment failure rate was 25 and 67%, respectively (P=0.013). In multivariate analysis, bitherapy including radiotherapy was the sole independent treatment failure risk factor (P=0.017). Two patient groups were defined, allowing to determine preoperatively good candidates and bad candidates for stress urinary incontinence treatment by InVance sling.