MP40-19 NON-OBSTRUCTIVE SLINGS (NOS) FOR STRESS URINARY INCONTINENCE AFTER PROSTATE SURGERY. ANALYSIS OF OUTCOMES IN DIFFERENT SUBGROUPS OF PATIENTS

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You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I (MP40)1 Apr 2020MP40-19 NON-OBSTRUCTIVE SLINGS (NOS) FOR STRESS URINARY INCONTINENCE AFTER PROSTATE SURGERY. ANALYSIS OF OUTCOMES IN DIFFERENT SUBGROUPS OF PATIENTS Giovanni Tasso*, Elodie Beels, Lina Del Favero, Simone Morselli, Mauro Gacci, Sergio Serni, Dirk De Ridder, and Frank Van der Aa Giovanni Tasso*Giovanni Tasso* More articles by this author , Elodie BeelsElodie Beels More articles by this author , Lina Del FaveroLina Del Favero More articles by this author , Simone MorselliSimone Morselli More articles by this author , Mauro GacciMauro Gacci More articles by this author , Sergio SerniSergio Serni More articles by this author , Dirk De RidderDirk De Ridder More articles by this author , and Frank Van der AaFrank Van der Aa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000889.019AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The efficacy of NoS for treatment of stress urinary incontinence (SUI) after prostatic surgery (PS) has been well established in patients not exposed to radiotherapy (RT) and with mild to moderate SUI. In a non-ideal population the evidence is less solid. Nevertheless, patients opt for sling surgery, even if they have bad prognostic factors. We analysed the outcomes of AdVance (AdV) and AdVance XP (AdV-XP) slings on our cohort of patients with different preoperative features and we calculated the risk factors for failure. METHODS: A consecutive series of patients treated since 2007 was analysed. Pads/day use defined the SUI grade: mild ≤2 pads/day, moderate and severe (SSUI) respectively ≤4 pads/day or >4 pads/day. A urodynamic study (UDS) was performed before the implant. During follow up (FU), social continence (SC) defined the use of 1 pad/day, totally dry (TD) was used for no pad use. Success described a reduction in pad use ≥ 50%. A time-to-event model identified the risk factors, uni- and multi-variate analysis provided the Hazard Ratio (HR). RESULTS: Of 216 implanted slings, 43% had at least one risk factor: RT (n=41), SSUI (n=44), previous surgery for incontinence (IS) and urethral stricture (US) (n=39). 57% were ideal candidates: 81% of them achieved SC at last FU, 51% were TD. SC and TD outcomes were significantly less after RT (resp. 47%-18%), in SSUI patients (resp. 51%-32%), after IS (resp. 56%-44%) and after US (44%-9%). No erosions were observed. A high post-void residual volume (hPVR) after catheter removal was seen in 46 cases (21,3%) but spontaneously resolved in 94%. Two cases required sling transection due to persistent hPVR. Multivariate analysis showed 3 significant factors for impaired SC outcome: RT (HR:3,4), US (HR:2,4) and detrusor overactivity at UDS (HR:2,6). The analysis for the TD outcome showed again RT (HR:1,7) and leaking during UDS (HR:1,8) as factors for failure. An increased cystometric capacity was protective (HR: 0,9). For the risk of PVR, increasing age (OR: 0.68) was protective, history of US was a risk factor (OR: 2.59). CONCLUSIONS: Implantation of NoS is effective and safe. The undesired events are rare also on comorbid patients, most of these events are transient. RT and US should be carefully considered as they significantly impair outcomes. Source of Funding: NO © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e593-e593 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giovanni Tasso* More articles by this author Elodie Beels More articles by this author Lina Del Favero More articles by this author Simone Morselli More articles by this author Mauro Gacci More articles by this author Sergio Serni More articles by this author Dirk De Ridder More articles by this author Frank Van der Aa More articles by this author Expand All Advertisement PDF downloadLoading ...