Continence and complications rates after male slings as primary surgery for post-prostatectomy incontinence: A systematic review

Objectives: to analyze continence and complications rates after male slings as first line surgical treatment, in order to improve patient counseling for the management of SUI postprostatectomy. Method: A MedLine search using specified search terms was done on January 23, 2012. This research rendered 160 records. Results: No controlled trial was available for analysis. The majority of papers dealing with outcome and complications came from a few centres. At a median follow-up of 15 months the pooled cure rates for all kinds of slings was 77.4; in the AdVance group the pooled cure rates was 72.5%; in the InVance group it was 74.2% while in the Remeex group it was 84.3%. Conclusions: Only a few number observational studies addressed review selection criteria. The pooled overall cure rates is high but there are no data concerning reliable pre-and postoperative prognostic factors affecting treatment failure and complications rates, thus it is not possible to have suitable criteria for a better patient selection. The statistically pooled results obtained should be interpreted with caution because of several limitations due to several study selection limitations: observational study design, few number of analysed studies, heterogeneity, lack of outcome definition and standardisation, between-study variability, high risk of bias.