Male Perineal Sling Research Articles

Pubourethral and uterosacral male analogues suggest parallel male/female pelvic anatomy and symptom pathogenesis.

The thesis that functional/dysfunctional male/female pelvic floor anatomy are parallel, originated from two studies: a successful retropubic perineal male sling for post-prostatectomy stress urinary incontinence (SUI) and discovery of a male uterosacral ligament (USL) analogue, we named "prostatosacral ligament" (PSL). In 25 out of the studied 27 males (92.6%), it starts on both sides of the median sulcus of the prostate the ligament passes lateral to the rectum being fused with the lateral margin of the mesorectum before leaving it as it thins out to be attached posteriorly similar to the USL. The ultrasound data during straining in men and women showed the same three oppositely acting muscle vectors contracting around analogous ligaments, puboprostatic ligament (PPL) (male), and pubourethral ligament (PUL) (female). Further parallels were pubovesical ligaments (PVLs) and arc of Gilvernet as part of the continence and micturition mechanisms. Impressive evidence for parallel anatomy came from the successful cure of 22 males with post-prostatectomy SUI using a perineal retropubic tissue fixation system (TFS) minisling applied to the PPL using a similar methodology to that used in the female for PUL midurethral sling repair for cure of SUI. Laparoscopic evidence confirmed the prostate as a male analogue of the cervix, and PSLs as analogues of USLs: PSL origin from the prostate attached laterally to the mesorectum and inserted into the sacrum. Histologically, PSLs had identical features with USLs: collagen, elastin, smooth muscle, blood vessels and nerves. Virtually identical symptoms for "chronic prostatitis" (CP) and "posterior fornix syndrome" (PFS), such as chronic pelvic pain, overactive bladder (OAB), abnormal emptying, gave birth to the hypothesis, of a common pathogenesis for "CP" and "PFS", USL (or PSL) laxity. If this could be proven by "simulated operations", "CP", at least in theory, may be potentially correctible by PSL repair.

Adjustable Perineal Male Sling for the Treatment of Urinary Incontinence: Long-term Results

To present the long-term results in patients with urinary incontinence who were treated with adjustable perineal male sling. An adjustable male sling procedure was performed in 45 patients with a mean age of 67.6 ± 7.8 years who had urinary incontinence. The mean period between primary prostatic surgery and the sling procedure was 36.7 months. The difference between the classical sling and the adjustable one is a 10 cm tissue expander between the 2 layers of polypropylene mesh with an injection port. Adjustment of the sling was performed with saline via this port, in case of recurrence or persistence of incontinence. Mean follow-up was 48 ± 29 months. Average operative time was 101.1 ± 25.5 minutes (45-150). Median daily pad use in these patients decreased from 8(2-12) to 1(0-10) (P < .001). During long-term follow-up 37.8% used 0 pad daily, 28.9% used 1-2 pads daily, making the total success rate 66.7%. Complete dry rate was higher in patients with nonsevere incontinence compared to the others with severe incontinence (57.9% vs 23.1%, P = .029). Nevertheless, there was no significant difference in the case of total success rate (78.9% vs 57.7%, respectively; P = .135). Age was significantly greater in both complete dry group (71.1 ± 4.8 vs 65.4 ± 8.7) and total success group (70.1 ± 5.2 vs 62.4 ± 5.2) (P = .017 and P < .001, respectively). Adjustable male sling is an acceptable procedure with low complication rates especially in patients with mild and moderate incontinence. At the same time, this procedure may be offered to patients with previous incontinence surgery.

MP87-04 NATIONAL TRENDS IN UTILIZATION OF SURGICAL THERAPIES FOR POST-PROSTATECTOMY STRESS URINARY INCONTINENCE

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I1 Apr 2016MP87-04 NATIONAL TRENDS IN UTILIZATION OF SURGICAL THERAPIES FOR POST-PROSTATECTOMY STRESS URINARY INCONTINENCE Yahir Santiago-Lastra, J. Quentin Clemens, and Bahaa S. Malaeb Yahir Santiago-LastraYahir Santiago-Lastra More articles by this author , J. Quentin ClemensJ. Quentin Clemens More articles by this author , and Bahaa S. MalaebBahaa S. Malaeb More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2354AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The adoption of male perineal sling (MPS) procedures has been thought to increase steadily. Our aim was to evaluate the impact of MPS on utilization of the artificial urinary sphincter (AUS) using data from the vendor as well as regional varations. We hypothesize that despite increasing utilization of the MPS, AUS utilization has continued to steadily increase. METHODS We used sales and revenue unit data provided by American Medical Systems (Boston Scientific, Natick, MA) to retrospectively review the number of AUS (AMS 800) and MPS (AdVance Male Sling System, InVance Male Sling System) that were implanted in males with post-prostatectomy incontinence (PPI) nationwide for the years of 2001 to 2013. Sales results for the MPS were reported as growth rates in utilization, by using this formula: {(Present utilization value) minus (Initial year utilization value) / (Initial year utilization value)}. These are represented as percent growth rates by year. Regional standardized MPS utilization rate (per 100 000 persons) were measured using state/region population and urologist density data as obtained from the most recent AUA census. We excluded devices implanted for revision cases. RESULTS We identified 46,939 original AUS units implanted with patient identification forms (PIFs) reported from 2000-2013. A regression model for the effect of different age groups on the rate of utilization demonstrated that increasing age was associated with an increased rate of utilization of the AUS, with robust yearly increase in utilization for both the 60-69 age group and the 70+ age group, with a stable rate of utilization for men under age 59 (Adjusted R square=0.985, p<0.001). For the MPS, there was a peak in utilization in year 2009 that correlates significantly with utilization rates for the AdVance sling. Since 2009, the growth rate in MPS utilization has decreased significantly. Urologist density correlates with MPS utilization rates by state (p<0.002). No significant decline in overall AUS utilization was observed with the introduction of different male sling products. CONCLUSIONS AUS utilization in the treatment of PPI continues to increase despite introduction of various MPS devices, particularly for older men. Areas with a greater urologist density are associated with greater MPS utilization. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1115-e1116 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Yahir Santiago-Lastra More articles by this author J. Quentin Clemens More articles by this author Bahaa S. Malaeb More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Adjustable perineal male sling using tissue expander as an effective treatment of post-prostatectomy urinary incontinence

Purpose To report our intermediate experience in treating patients with severe incontinence using an adjustable perineal male sling with a tissue expander.Materials and Methods An adjustable male sling procedure was performed on 21 patients with severe incontinence. The underlying etiology of urinary incontinence was radical prostatectomy in 13 patients, open prostatectomy in 5 patients and transurethral prostate resection in 3 patients. The difference between the classical and the adjustable sling is that in the latter there is a 25 mL tissue expander between the two layers of polypropylene mesh with an injection port. Adjustment of the sling was performed with saline via an inflation port, in case of recurrence or persistence of incontinence.Results The mean age of the patients was 66.2±7.3 (50-79) years and mean pad usage was 6.4±0.6 per day. The mean follow-up time was 40.1±23.2 (6-74) months. The balloon was postoperatively inflated on average with 11.6±5.7 (5-25) mL. After the mean 40.1 months of follow-up, 16 of the 21 patients (76.2%) were dry (11 patients, 0 pads; 5 patients using safety pads), 3 patients (14%) had mild and 2 (9.8%) had moderate degree post-prostatectomy urinary incontinence (PPI). The average maximum urine flow rate of the patients was 15.6±4.7 (10-31) mL/s. No residual urine was found. In 2 patients, all parts of the device were removed due to infection and discomfort, and in 3 patients only the inflation component was removed due to local scrotal infection.Conclusions Our results show that using an adjustable perineal male sling with a tissue expander seems to be an efficient, and safe surgical treatment option in patients with PPI.

POD-1.04: The bone-anchored perineal male sling for post-prostatectomy incontinence: results up to 5 years of follow-up

POD-1.04: The bone-anchored perineal male sling for post-prostatectomy incontinence: results up to 5 years of follow-up

Association Between Detrusor Overactivity and Postoperative Outcomes in Patients Undergoing Male Bone Anchored Perineal Sling

In this study we determined if there was an association between the presence of preoperative detrusor overactivity and patient outcomes after bone anchored perineal sling. A total of 85 men underwent a male perineal sling procedure for urodynamically proven stress urinary incontinence. Preoperative history and physical examination were performed, and patients completed self-assessment questionnaires. Based on urodynamics patients were divided into 2 groups of those with and those without detrusor overactivity. Questionnaires including the Patient Global Impression of Improvement Scale were readministered postoperatively. Success was defined by the Patient Global Impression of Improvement as very much better or much better. Failure was defined by the responses of a little better, no change, a little worse or much worse. Successes and failures were compared to the presence of detrusor overactivity. Preoperative parameters, preoperative and postoperative questionnaire scores, and postoperative pad and anticholinergic use were compared between the 2 groups. A total of 72 patients were included in the analysis, and of these 22 (30.6%) had detrusor overactivity and 50 (69.4%) did not. All patients completed the Patient Global Impression of Improvement. There was no statistical difference in the number of cases classified as successes or failures in the 2 groups (p = 0.4213). A significantly higher percentage of patients with detrusor overactivity required postoperative anticholinergics. There was no statistical difference in the number of patients using pads postoperatively. Preoperative detrusor overactivity was not associated with worse postoperative outcomes. Men with urodynamic stress urinary incontinence and detrusor overactivity may be considered for a male sling procedure. However, they may require postoperative anticholinergics and should be counseled accordingly.

Transobturator male sling TOMS™ for the treatment of stress post-prostatectomy incontinence, initial experience and results with one year's experience

Post-prostatectomy incontinence remains a problem, even in minor or moderate degrees. In order to minimize surgical morbidity and costs, sling procedures have been proposed. The authors have developed a new transobturator male sling procedure and report their results after one-year experience. A prospective multicenter study was conducted in 50 patients with minor or moderate post-prostatectomy incontinence. Evaluation of TOMS two arms bulbar sling was based on clinical form assessment, The International Consultation on Incontinence Questionnaire (ICIQ) and short-form (SF) 36 questionnaire pre and postoperatively and at 3, 6, 9 and 12 months. The surgical procedure was considered easy to perform and no post-surgery complication was reported except for one retention. The median number of pads per day decreased significantly from 2 pads before surgery (95% CI: 2 - 3) to 1 during the follow-up period (95% CI: 0 - 2 at 360 days), and at 3 months patients using none or one pad per day were 30% and 32% respectively. The SF 36 continence and quality of life score improved from a median of 100 (95% CI: 83 - 133) to 300 (95% CI: 167 - 375), and the median ICIQ incontinence and quality of life score decreased from 15 (95% CI: 14 - 16) to 8 (95% CI: 5 - 12) one year after surgery. The transobturator perineal male sling TOMS is an attractive simple sling technique for moderate or minor post-prostatectomy stress incontinence and offers an improvement in the quality of life.

UP-1.188: Treatment Parameters for the Bone Anchored Male Perineal Sling

The increasing popularity of radical prostatectomy for the treatment of clinically localised prostate cancer over the last fifteen years has led to an increased incidence of post-prostatectomy incontinence. Whilst the artificial urinary sphincter remains the gold standard for the treatment of male incontinence, a number of sling based therapies have emerged over the last 5 years. This study examines selection criteria and outcomes with the InVance® male sling.

Outpatient Perineal Sling in Adolescent Boys With Neurogenic Incontinence

Management for urinary incontinence in boys with sphincteric incompetence secondary to a neurogenic etiology is a challenge. Minimally invasive approaches have inconsistent efficacy and may require multiple treatments. Open bladder neck reconstruction requires inpatient hospitalizations and can be associated with a high complication rate. To overcome some of these shortcomings we placed a polypropylene male perineal sling in male adolescents with neurogenic sphincteric incontinence. We retrospectively reviewed the outcome in our initial 6 patients. Six patients 14 to 20 years old underwent placement of a polypropylene male perineal sling on an outpatient basis. Followup was 27 to 39 months (median 33). All patients had a history of myelomeningocele and underwent urodynamics showing normal compliance, adequate capacity and sphincteric incompetence. A suburethral sling was placed on an outpatient basis through a small perineal incision. Sling tension was adjusted for maximal urethral compression while still permitting uncomplicated urethral catheter passage. All 6 patients reported immediate complete continence after sling placement. Two slings were removed after local infection developed and 1 was replaced. Another sling required revision secondary to incomplete bone anchor fixation. No patients had urethral erosion. All 5 patients with a sling currently in place were fully continent on intermittent catheterization every 3 hours and they reported excellent satisfaction with the procedure. Our retrospective study suggests that the male urethral sling may be an outpatient option for neurogenic incontinence secondary to sphincteric incompetence. Long-term followup in our initial 6 patients shows encouraging durability. Continued study is required to determine strategies that might decrease the complication rate of this approach.

Intermediate‐term results, up to 4 years, of a bone‐anchored male perineal sling for treating male stress urinary incontinence after prostate surgery

To examine the intermediate-term outcome (up to 4 years) of a bone-anchored perineal sling (InVance(TM), American Medical Systems, Minnetonka, MN, USA) in men with stress urinary incontinence (SUI) after prostate surgery. In all, 62 men with SUI were implanted with the InVance sling. SUI was diagnosed after radical prostatectomy in 58 patients and after benign prostatic hyperplasia (BPH) prostatectomy in four patients. Implantation of the InVance bone-anchored bulbourethral sling was conducted primarily under spinal anaesthesia. Patients were considered cured, if they stopped wearing continence pads and improved if the daily number of pads used decreased by at least half. The Incontinence Quality of Life questionnaire and a simple verbal question about patient satisfaction with the surgery were also used and complications were measured. In all, 40 patients (65%) were cured and 14 (23%) were improved after a mean follow-up of 28 months. The UI cure rates at 3 and 4 years follow-up were 70% and 66%, respectively. The most common side-effect was transient scrotal or perineal pain or numbness, which affected 12 patients (19%). There was a prolonged postvoid residual urine volume of >100 mL in six patients (10%), which resolved within 2 weeks of indwelling catheterization. Explantation of the sling was required in two cases (3%) because of infection. In one patient (2%), revision was required for bone-anchor dislodgement. The InVance sling offers good intermediate-term cure and improvement rates for SUI after prostatectomy. The procedure has an acceptably low rate of minor complications, and should be considered for treating men with less severe forms (< or =5 pads per day) of SUI.

Artificial Urinary Sphincter Versus Male Sling for Post-Prostatectomy Incontinence—What Do Patients Choose?

Early outcomes of the male sling to correct post-prostatectomy incontinence have been promising in select patients. Long-term data are lacking to determine whether the male sling is as effective as the artificial urinary sphincter, which is the current gold standard. Because the male sling offers the significant advantage of avoiding a mechanical device but without established success, we determined the patient preference for the male sling vs the artificial urinary sphincter. We reviewed the charts of 133 men with post-prostatectomy incontinence who underwent the first procedure to correct incontinence. After urodynamics the surgeon recommended an artificial urinary sphincter or a male sling and patients were told the artificial urinary sphincter satisfaction rate and shorter term data on the male sling. Patients with high grade post-prostatectomy incontinence (pad weight greater than 400 gm/24 hours) were recommended to receive an artificial urinary sphincter, those with moderate post-prostatectomy incontinence (pad weight 100 to 400 gm/24 hours) were recommended to receive an artificial urinary sphincter or a male sling and those with mild post-prostatectomy incontinence (pad weight less than 100 gm/24 hours) were recommended to receive a male sling. A total of 84 male sling (63%) and 49 artificial urinary sphincter (37%) procedures were performed. The surgeon recommendation was an artificial urinary sphincter in 63 men (47%) and a male sling in 46 (35%). A total of 24 men (18%) were given the option of either procedure. All patients recommended to receive a male sling chose it. When an artificial urinary sphincter was recommended, 75% of patients chose it, while 25% chose a male sling. When given a choice, 92% of patients chose a male sling and 8% chose an artificial urinary sphincter. Most patients adhere to the surgeon recommendation. When men with post-prostatectomy incontinence are offered the choice of an artificial urinary sphincter vs a male sling, the opportunity to avoid using a mechanical device is preferable to undergoing a well established procedure. Men who strongly wish to avoid a mechanical device are willing to go against the surgeon recommendation for an artificial urinary sphincter.

Combination therapy for male erectile dysfunction and urinary incontinence

Urinary incontinence (UI) and erectile dysfunction (ED) are both very prevalent conditions. Insertion of an artificial urinary sphincter (AUS) and penile prosthesis (PP) is an effective and proven method of treatment for both conditions. With advancing age, as well as with increasing populations of patients radically treated for prostate cancer, the occurrence of both conditions found in the same patient is increasing. The purpose of this article was to analyze the available evidence for simultaneous surgical management of male ED and UI using prosthetic devices. The existing literature pertaining to dual implantation of AUS and PP was reviewed. The concomitant insertion of the PP with the male perineal sling was also considered. Concurrent ED and UI are increasingly seen in the post radical prostatectomy population, who are often younger and less willing to suffer with these conditions. Insertion of an AUS and PP, either simultaneously or as a two-stage procedure, appears to be a safe, efficacious and long-lasting method of treatment. The improvements in design of both the AUS and PP as well as the development of the single transverse scrotal incision have made simultaneous insertion of these prostheses possible. Dual implantation of the PP and male sling looks promising in a selected population. In conclusion, the insertion of the AUS and PP for the treatment of concurrent UI and ED is safe and effective. Simultaneous insertion of these prostheses in the same patient offers potential advantages in operative and recovery time and is associated with high patient satisfaction. Combination therapy should therefore be included in the arsenal of treatment of these conditions.

A New Device for the Treatment of Post-Prostatectomy Incontinence: Adjustable Perineal Male Sling

We describe a novel male sling device for the treatment of post-prostatectomy incontinence that allows tension adjustment over the urethra postoperatively. We report the short-term results in patients with severe incontinence who were treated with this device. An adjustable male sling procedure was performed in 19 patients with a mean age of 67.5 years (range 59 to 80) who had severe post-prostatectomy incontinence. A tissue expander, including a silicone balloon expander, a small tube and a self-sealing valve that allowed the expander to gradually fill with saline solution, was used for this procedure. A pocket was created to anchor the balloon expander in its position by suturing 2 polypropylene meshes to each other around the filled balloon expander. The empty silicone balloon expander was inserted into this pocket and the sling was placed over the urethra. The injection port was secured inside the scrotum and connected to the balloon expander. Average operative time was 63 minutes (range 45 to 90). A total of 11 patients required injections. The average number of adjustments was 2 (range 1 to 3) and average injected volume was 6.3 cc (range 5 to 10). Of the patients 15 (78.9%) were completely dry and 2 (10.5%) improved significantly to 1 to 2 pads per day at a mean followup of 17.3 months (range 12 to 25). Our short-term results suggest that a tissue expander makes the male sling procedure more effective. However, since it is a new device, long-term results are needed to evaluate durability.

The Male Perineal Sling: Assessment and Prediction of Outcome

The male perineal sling has become an option for treating male stress incontinence. We evaluated its overall efficacy and determined preoperative parameters that could predict success. A total of 62 men with stress incontinence were prospectively evaluated and underwent a male perineal sling. Preoperatively 24-hour pad weight, urodynamics and a number of validated incontinence questionnaires were completed. At a minimum of 3 months of followup 24-hour pad weight and questionnaires were repeated. Success was assessed using the 1 question Patient Global Impression of Improvement. The Patient Global Impression of Improvement was compared to a number of other subjective and objective measures of outcome. Finally, preoperative parameters were evaluated to determine predictors of outcome. As determined by the Patient Global Impression of Improvement, the success rate was 58%. The only preoperative factor predictive of success was 24-hour pad weight. An individual had a 71% chance of successful surgery if preoperative pad weight was less than 423 gm. There was a statistically significant difference between successes and failures in terms of postoperative pad weight and certain questionnaires, including the UCLA/RAND Prostate Cancer Index urinary function score, International Consultation on Incontinence short form, Incontinence Impact Questionnaire, Urogenital Distress Index and International Prostate Symptom Score. The overall complication rate was 21% and the reoperation rate was 14.5%. The male perineal sling can be an effective surgical treatment for stress incontinence in the appropriate patient. The procedure is most successful in patients with lesser objective degrees of incontinence. The Patient Global Impression of Improvement is an effective tool for assessing outcome for this population.

The male perineal sling for the treatment of neurogenic urinary incontinence

Purpose The treatment of the incompetent bladder neck in boys with neurogenic bladders is difficult. We have adapted the AMS Invance sling to treat this group of patients. This device was originally developed to treat urinary incontinence post-radical prostatectomy. Material and methods The InVance male sling system (AMS) was used in 4 boys with a history of spina bifida and urinary incontinence. The boys ranged in age from 15 years to 19 years. Follow-up ranges to 18 months. Urodynamics confirmed low leak point pressures and adequate vesical compliance and capacity. The procedure was performed on an out-patient basis. A silicone coated polyester sling was placed through a perineal incision. Three titanium screws were used in conjunction with polypropylene sutures to secure the sling on either descending pubic rami. Results A total of five slings were placed in 4 patients. One sling required replacement secondary to inadequate fixation. One sling was removed after a local wound infection developed. Of the 3 patients with the sling in place, all are completely continent. They are able to perform intermittent catheterization without difficulty. Conclusions This out-patient technique offers the potential of achieving long-term urinary continence in boys using a perineal based sling. Further studies of this approach are warranted based on these preliminary results. The treatment of the incompetent bladder neck in boys with neurogenic bladders is difficult. We have adapted the AMS Invance sling to treat this group of patients. This device was originally developed to treat urinary incontinence post-radical prostatectomy. The InVance male sling system (AMS) was used in 4 boys with a history of spina bifida and urinary incontinence. The boys ranged in age from 15 years to 19 years. Follow-up ranges to 18 months. Urodynamics confirmed low leak point pressures and adequate vesical compliance and capacity. The procedure was performed on an out-patient basis. A silicone coated polyester sling was placed through a perineal incision. Three titanium screws were used in conjunction with polypropylene sutures to secure the sling on either descending pubic rami. A total of five slings were placed in 4 patients. One sling required replacement secondary to inadequate fixation. One sling was removed after a local wound infection developed. Of the 3 patients with the sling in place, all are completely continent. They are able to perform intermittent catheterization without difficulty. This out-patient technique offers the potential of achieving long-term urinary continence in boys using a perineal based sling. Further studies of this approach are warranted based on these preliminary results.

Male Bulbourethral Sling After Radical Prostatectomy: Intermediate Outcomes at 2 to 4-Year Followup

We reviewed our experience with 49 consecutive patients undergoing a male sling procedure. The 7-item International Prostate Symptom Score and 22-item incontinence quality of life questionnaire (although not validated in Italian) were used to assess the clinical impact of the bulbourethral sling. Surgical outcome was also assessed by videourodynamics at 1 year. Urodynamic success was defined as no leakage during videourodynamic evaluation. Mean followup was 32 months (range 26 to 48). Preoperatively 3 patients used 2 pads daily (mild incontinence), 34 used 3 to 5 (moderate incontinence) and the remaining 12 used more than 5 (severe incontinence). Clinical success was defined as a decrease in pad use to completely dry (no pad) or to social continence (1 pad daily) at followup. Of the 49 patients 38 (77%), 33 (67%) and 63% (31) were considered socially continent at the 3-month, 1-year and 3-year followup, respectively. Only 15 of the 49 patients (30%) were considered completely dry at the 3-year followup. Significant perineal pain was reported in the early postoperative period but it resolved in all patients. Infection occurred in 3 patients, while no erosion was found. The male perineal sling is a safe surgical option for post-prostatectomy urinary incontinence, especially when strict patient selection is done. Patient satisfaction is superior to urodynamic results and the procedure allows physiological voiding. Patients should be informed of the possibility of progressive failure with time and significant perineal pain in the early postoperative period.

Comparison between reduction in 24‐hour pad weight, International Consultation on Incontinence‐Short Form (ICIQ‐SF) score, International Prostate Symptom Score (IPSS), and Post‐Operative Patient Global Impression of Improvement (PGI‐I) score in patient evaluation after male perineal sling

We assessed the utility of three self-assessment instruments: the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the post-operative Patient Global Impression of Improvement (PGI-I) score, and the International Prostate Symptom Score (IPSS) by correlating them with an objective outcome, the change in 24-hr pad weight, after a male perineal sling. Twenty-six men with urodynamically confirmed stress incontinence underwent a male perineal sling. Patients were evaluated pre-operatively and post-operatively with a 24-hr pad test, IPSS and ICIQ-SF. Patients also completed the PGI-I post-operatively. Changes in study parameters were compared via the paired t-test, and correlations were performed using Spearman's rho. There were significant reductions in 24-hr pad weight (-274 g, P < 0.001), percentage 24-hr pad weight (54.2%), ICIQ-SF score (-6.3, P < 0.001), and the three ICIQ-SF subscores (-1.2, -1.7, -3.4 for Questions 3, 4, and 5, respectively, P < 0.001 for all). The change in total ICIQ-SF score and the post-operative PGI-I score correlated strongly with percentage reduction in 24-hr pad weight (r = -0.68, P < 0.001; r = -0.81, P < 0.001, respectively) and with each other (r = 0.79, P < 0.001). The change in all three ICIQ-SF subscores correlated significantly with percentage reduction in 24-hr pad weight and with post-operative PGI-I score. There was no significant change in the IPSS or the voiding or storage subscores, and none correlated with any other study parameter. This study validates the construct validity of the ICIQ-SF and PGI-I in the assessment of treatment for male stress incontinence and should make clinicians confident in comparing studies of incontinence treatment utilizing the change ICIQ-SF score, the post-operative PGI-I score, and percentage reduction in 24-hr pad weight as outcome measures.

357: Comparison Between Change in 24-Hour Pad Weight, AUA Symptom Score, ICIQ-SF Score, and PGI-I Score in Patient Evaluation after Male Perineal Sling

357: Comparison Between Change in 24-Hour Pad Weight, AUA Symptom Score, ICIQ-SF Score, and PGI-I Score in Patient Evaluation after Male Perineal Sling

1365: Predictive Factors for Involuntary Detrusor Contractions on Preoperative Urodynamics in Patients Undergoing Male Perineal Sling

You have accessJournal of UrologyModerated Poster, Tuesday, May 23, 2006, 1:00 - 3:00 pm1 Apr 20061365: Predictive Factors for Involuntary Detrusor Contractions on Preoperative Urodynamics in Patients Undergoing Male Perineal Sling Melissa C. Fischer, Christian O. Twiss, and Victor W. Nitti Melissa C. FischerMelissa C. Fischer More articles by this author , Christian O. TwissChristian O. Twiss More articles by this author , and Victor W. NittiVictor W. Nitti More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)33578-XAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1365: Predictive Factors for Involuntary Detrusor Contractions on Preoperative Urodynamics in Patients Undergoing Male Perineal Sling." The Journal of Urology, 175(4S), p. 440 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 175Issue 4SApril 2006Page: 440 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Melissa C. Fischer More articles by this author Christian O. Twiss More articles by this author Victor W. Nitti More articles by this author Expand All Advertisement PDF DownloadLoading ...

1364: Association between Involuntary Detrusor Contractions on Preoperative Urodynamics and Postoperative Outcomes in Patients Undergoing Male Perineal Sling

You have accessJournal of UrologyModerated Poster, Tuesday, May 23, 2006, 1:00 - 3:00 pm1 Apr 20061364: Association between Involuntary Detrusor Contractions on Preoperative Urodynamics and Postoperative Outcomes in Patients Undergoing Male Perineal Sling Melissa C. Fischer, Christian O. Twiss, and Victor W. Nitti Melissa C. FischerMelissa C. Fischer More articles by this author , Christian O. TwissChristian O. Twiss More articles by this author , and Victor W. NittiVictor W. Nitti More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)33577-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1364: Association between Involuntary Detrusor Contractions on Preoperative Urodynamics and Postoperative Outcomes in Patients Undergoing Male Perineal Sling." The Journal of Urology, 175(4S), p. 440 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 175Issue 4SApril 2006Page: 440 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Melissa C. Fischer More articles by this author Christian O. Twiss More articles by this author Victor W. Nitti More articles by this author Expand All Advertisement PDF downloadLoading ...