Functional follow-up after Advance® and Advance XP® male sling surgery: assessment of predictive factors
To evaluate the efficacy of the Advance® and AdvanceXP® slings in men with stress urinary incontinence (SUI) post-radical prostatectomy and to identify predictive factors for outcome.
Included were male patients with SUI following radical prostatectomy who had a positive “repositioning test”, 24 h-pad weight (PW) test < 400 g and who were continent at night and at rest. Urgency was defined as a sudden compelling desire to pass urine, which was difficult to defer. The cure rate was defined as no pad use.
From February 2008 to October 2014, 24 AdVance® and 70 AdVance XP® were implanted. The median (range) follow-up was 49 (12–102) months. The overall cure rate was 77%. The preoperative 24 h PW was significantly related to the continence outcome (p = 0.044). A total of 12 patients (13%) presented with postoperative AUR, which was significantly related to abnormal voiding detrusor activity (p = 0.036). Twenty-two patients (23%) had postoperative urgency (16% “de novo”), which was significantly related to preoperative urgency (p = 0.003). During follow-up, a degree of deterioration of continence was observed in five patients who were classed as cured initially. To date, no reports of urethral sling erosion have been made.
The AdVance® and AdVanceXP® slings are safe and effective in relieving SUI following post-radical prostatectomy. There were no differences between the two slings in terms of efficacy, urgency or postoperative AUR. There was a moderate rate of “de novo “urgency and low rate of loss of continence during follow-up.
KeywordsIncontinence Radical prostatectomy Advance® sling Urgency Acute urinary retention
The authors would like to acknowledge the contributions of Mª del Carmen Rodríguez and Maria Serrano, nurses in the Urology Dept, Fundación IVO, Valencia, Spain.
ACS and JR-B designed of the research study. ACS and JD-E acquisition of data. ACS and MR-B drafting the manuscript. JD-E and JR-B performed the research. IMOR and ACS analysis and interpretation of the data. CRT and IMOR statistical analysis
Compliance with ethical standards
Conflict of interest
Argimiro Collado Serra: Surgical trainer for AMS-800 and AdVance (Boston Scientific) and Virtue (Coloplast). José Domínguez-Escrig, Isabel María Ortiz Rodríguez, Miguel Ramirez-Backhaus, Carmelo Rodríguez Torreblanca and José Rubio-Briones have declared that they have no conflict of interest
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All applicable international, national and/or institutional guidelines for the care and use of animals were followed.
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