World Journal of Urology

, Volume 37, Issue 1, pp 195–200 | Cite as

Functional follow-up after Advance® and Advance XP® male sling surgery: assessment of predictive factors

  • Argimiro ColladoEmail author
  • José Domínguez-Escrig
  • Isabel María Ortiz Rodríguez
  • Miguel Ramirez-Backhaus
  • Carmelo Rodríguez Torreblanca
  • José Rubio-Briones
Original Article



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.


Incontinence 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.

Author contributions

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

Ethical approval

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.


  1. 1.
    Bauer RM, Mayer ME, May F, Gratzke C, Buchner A, Soljanik I, Bastian PJ, Stief CG, Gozzi C (2010) Complications of the AdVance transobturator male sling in the treatment of male stress urinary incontinence. Urology 75:1494–1498CrossRefGoogle Scholar
  2. 2.
    Berry JL (1961) A new procedure for correction of urinary incontinence: preliminary report. J Urol 85:771–775CrossRefGoogle Scholar
  3. 3.
    Rehder P, Gozzi C (2007) Transobturator sling suspension for male urinary incontinence including post-radical prostatectomy. Eur Urol 52:860–866CrossRefGoogle Scholar
  4. 4.
    Bauer RM, Gozzi C, Klehr B, Kretschmer A, Grabbert M, Rehder P, May F, Stief CG, Gebhartl P, Homberg R (2016) AdVanceXP male sling: 2-year results of a multicentre study. World J Urol 34:1025–1030CrossRefGoogle Scholar
  5. 5.
    Davies TO, Bepple JL, McCammon KA (2009) Urodynamic changes and initial results of the AdVance male sling. Urology 74:354–357CrossRefGoogle Scholar
  6. 6.
    Collado A, Resel L, Dominguez-Escrig JL, Gomez-Ferrer A, Rubio-Briones J, Solsona E (2013) AdVance/AdVance XP transobturator male slings: preoperative degree of incontinence as predictor of surgical outcome. Urology 81:1034–1039CrossRefGoogle Scholar
  7. 7.
    Bauer RM, Soljanik I, Fullhase C, Karl A, Becker A, Stief CG, Gozzi C (2011) Mid-term results for the retroluminar transobturator sling suspension for stress urinary incontinence after prostatectomy”. BJU Int 108:94–98CrossRefGoogle Scholar
  8. 8.
    Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178CrossRefGoogle Scholar
  9. 9.
    Jura YH, Comiter CV. Urodynamics for postprostatectomy incontinence: when are they helpful and how do we use them? (2014) Urol Clin N Am 41:419–427, viiiGoogle Scholar
  10. 10.
    Groutz A, Blaivas JG, Chaikin DC, Weiss JP, Verhaaren M (2000) The pathophysiology of post-radical prostatectomy incontinence: a clinical and video urodynamic study. J Urol 163:1767–1770CrossRefGoogle Scholar
  11. 11.
    Elliott CS, Comiter CV (2012) Maximum isometric detrusor pressure to measure bladder strength in men with postprostatectomy incontinence”. Urology 80:1111–1115CrossRefGoogle Scholar
  12. 12.
    Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, Van KP, Victor A, Wein A (2003) The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 61:37–49CrossRefGoogle Scholar
  13. 13.
    Cardozo L, Amarenco G, Pushkar D, Mikulas J, Drogendijk T, Wright M, Compion G, Group SS (2013) Severity of overactive bladder symptoms and response to dose escalation in a randomized, double-blind trial of solifenacin (SUNRISE). BJU Int 111:804–881CrossRefGoogle Scholar
  14. 14.
    Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M (2009) The Clavien-Dindo classification of surgical complications: five-year experience”. Ann Surg 250:187–196CrossRefGoogle Scholar
  15. 15.
    Cornu JN, Sebe P, Ciofu C, Peyrat L, Cussenot O, Haab F (2011) Mid-term evaluation of the transobturator male sling for post-prostatectomy incontinence: focus on prognostic factors. BJU Int 108:236–240CrossRefGoogle Scholar
  16. 16.
    Rapoport D, Walter J, Borawski K, Webster GD (2009) The Advance male sling: predictors of success. J Urol 181:619–619CrossRefGoogle Scholar
  17. 17.
    Kowalik CG, DeLong JM, Mourtzinos AP (2015) The advance transobturator male sling for post-prostatectomy incontinence: subjective and objective outcomes with 3 years follow up”. Neurourol Urodyn 34:251–254CrossRefGoogle Scholar
  18. 18.
    Rehder P, Haab F, Cornu JN, Gozzi C, Bauer RM (2012) Treatment of postprostatectomy male urinary incontinence with the transobturator retroluminal repositioning sling suspension: 3-year follow-up. Eur Urol 62:140–145CrossRefGoogle Scholar
  19. 19.
    Cornu JN, Sebe P, Ciofu C, Peyrat L, Beley S, Tligui M, Lukacs B, Traxer O, Cussenot O, Haab F (2009) The AdVance transobturator male sling for postprostatectomy incontinence: clinical results of a prospective evaluation after a minimum follow-up of 6 months. Eur Urol 56:923–927CrossRefGoogle Scholar
  20. 20.
    Barnard J, van Rij S, Westenberg AM (2014) A Valsalva leak-point pressure of > 100 cmH2O is associated with greater success in AdVance sling placement for the treatment of post-prostatectomy urinary incontinence”. BJU Int 114(Suppl 1):34–37CrossRefGoogle Scholar
  21. 21.
    Li H, Gill BC, Nowacki AS, Montague DK, Angermeier KW, Wood HM, Vasavada SP (2012) Therapeutic durability of the male transobturator sling: midterm patient reported outcomes. J Urol 187:1331–1335CrossRefGoogle Scholar
  22. 22.
    Soljanik I, Gozzi C, Becker AJ, Stief CG, Bauer RM (2012) Risk factors of treatment failure after retrourethral transobturator male sling”. World J Urol 30:201–206CrossRefGoogle Scholar
  23. 23.
    Bauer RM, Kretschmer A, Stief CG, Fullhase C (2015) AdVance and AdVance XP slings for the treatment of post-prostatectomy incontinence”. World J Urol 33:145–150CrossRefGoogle Scholar
  24. 24.
    Hall M, Polland A, Weissbart S, Mock S, Grafstein N (2014) Prognostic value of postoperative urinary retention after male sling insertion. Can J Urol 21:7344–7349Google Scholar
  25. 25.
    Zuckerman JM, Edwards B, Henderson K, Beydoun HA, McCammon KA (2014) Extended outcomes in the treatment of male stress urinary incontinence with a transobturator sling”. Urology 83:939–945CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Argimiro Collado
    • 1
    Email author
  • José Domínguez-Escrig
    • 1
  • Isabel María Ortiz Rodríguez
    • 2
  • Miguel Ramirez-Backhaus
    • 1
  • Carmelo Rodríguez Torreblanca
    • 2
  • José Rubio-Briones
    • 1
  1. 1.Department of UrologyFundación IVO C/Beltrán BáguenaValenciaSpain
  2. 2.Department of MathematicsUniversidad de AlmeríaAlmeríaSpain

Personalised recommendations