V02-10 LONG TERM EVALUATION OF THE ARGUS-T® ADJUSTABLE MALE SLING: A PROSPECTIVE STUDY

Abstract

You have accessJournal of UrologyCME1 May 2022V02-10 LONG TERM EVALUATION OF THE ARGUS-T® ADJUSTABLE MALE SLING: A PROSPECTIVE STUDY Rafael Zanotti, André Costa Matos, Felipe Pinho, Claudio Hideki Toi, Sergio Paolillo, Giovani Demartino, Marcel Takada, Bruno Hirata, and Luís Gustavo Morato de Toledo Rafael ZanottiRafael Zanotti More articles by this author , André Costa MatosAndré Costa Matos More articles by this author , Felipe PinhoFelipe Pinho More articles by this author , Claudio Hideki ToiClaudio Hideki Toi More articles by this author , Sergio PaolilloSergio Paolillo More articles by this author , Giovani DemartinoGiovani Demartino More articles by this author , Marcel TakadaMarcel Takada More articles by this author , Bruno HirataBruno Hirata More articles by this author , and Luís Gustavo Morato de ToledoLuís Gustavo Morato de Toledo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002528.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Male slings are attractive alternatives for the treatment of post prostatectomy urinary incontinence (PPI). In this study and accompanying video, our purpose is to report our findings of up to 12 years of follow up and the technical details that led us to our results. METHODS: From 06/2009 to 09/2021, 89 patients with PPI underwent male Argus-T® adjustable sling implantation. We prospectively recorded their data.Prior to implantation and during follow up, patients were acessed through clinical evaluation, 24h pad-test, ICIQ-SF and complications. Clinical and urodynamic variables were correlated to the need for readjustments. Success was defined by cure or improvement. The definition of objective cure was dry patient; of improvement, decrease >50% number of pads; of fail, decrease <50% number of pads. The definition of subjective cure was VAS >=8 and PGI-I “much better”; of improvement, VAS 6-7 and PGI-I “little better”; of fail, VAS <=5 or unchanged. RESULTS: The median follow up was 96 (13 - 144) months. In our series 22 patients (24,6%) had mild, 23 (26,1%) moderate and 44 (49,3%) severe incontinence. 20 patients (22,5%) had received previous radiotherapy and 18 (19,7%) previous urethral stricture treatment. Within the whole series, 75 patients (85,4%) achieved subjective success (74,4% cure + 11% improvement) and 71 (80,5%) objective success (65,9% cure + 14,6% improvement). Readjustments were necessary in 23 (25,8%) cases. Considering only the subgroups of patients who received previous radiotherapy and/or previous urethral stricture treatment, 66,7% needed readjustments. We found that these are predictor factors for the need of readjustments (p 0,001). Complications included: 2 cases of protusion of silicon arms to the scrotal skin; 2 of inguinal granuloma. 7 cases of urinary retention that resolved with indwelling catheter for 7 to 10 days. Device removal was necessary in 5 cases, 4 due to infection and 1 due to persistent urinary retention and severe pain. No cases of device components explantation were reported. Curiously, 3 of the 5 patients who had their devices removed remained dry, removal occurred about 2 years after surgery. CONCLUSIONS: We found similar success rates than previously published for this device, however adverse events are lower, especially regarding to sling removal. Previous radiotherapy and urethral stricture treatment are predictor factors for the need for readjustments. Adjustability benefits a significant number of patients who would have failed. Especially those with worse prognostic factors; maintaining the success rates of this group similar to the group without these factors. Argus-T has high and maintained success rate. Good outcomes can be achieved even for moderate to severe incontinence cases. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e113 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rafael Zanotti More articles by this author André Costa Matos More articles by this author Felipe Pinho More articles by this author Claudio Hideki Toi More articles by this author Sergio Paolillo More articles by this author Giovani Demartino More articles by this author Marcel Takada More articles by this author Bruno Hirata More articles by this author Luís Gustavo Morato de Toledo More articles by this author Expand All Advertisement PDF DownloadLoading ...