Long-term Follow-up of the Virtue Quadratic Male Sling

Abstract

To report our long-term outcomes of Virtue Quadratic (VQ) sling since male slings have been introduced as a potential alternative treatment option to the artificial urinary sphincter (AUS), with limited long-term data available for proof of efficacy. Herein, we report our data. A retrospective review was performed on all Virtue slings performed at our institution over a 2-year period. Patient-reported outcomes regarding procedure success, complications, as well as subsequent procedures were identified. Procedure failure was defined as the inability to reduce patient's preoperative pad use, sling explant for complications, and need for AUS due to continued incontinence. We identified 32 consecutive male patients who were implanted with the VQ sling over the study period. One patient was excluded due to no follow-up. Median follow-up was 55 months. Median preoperative and postoperative pads per day were 3 (interquartile range: 1-3) and 2 (1-2.5). There were 21 (68%) patients who were considered procedure failures. Two (7%) patients reported chronic pain following placement and 7 (22%) underwent subsequent sling explant due to pain or for failure (1 vs 6). Six (20%) patients underwent subsequent AUS placement. Failure was more likely in patients with external beam radiation therapy (6, 19%) (P = .02). There was no association between procedure failure with age (P = .65) or severity of incontinence (P = .17). This study demonstrated a significant procedure failure and complication rate with the VQ sling. Thus, we do not recommend the use of the VQ sling and have abandoned all further implantation of the device.