Mid-term results for the retroluminar transobturator sling suspension for stress urinary incontinence after prostatectomy

OBJECTIVE To evaluate prospectively the efficacy of the retroluminar transobturator male sling (AdVance (R) sling) for the functional treatment of stress urinary incontinence (SUI) after prostatectomy. PATIENTS AND METHODS A total of 137 patients with grade II-IV SUI, resulting from radical prostatectomy, were treated with the AdVance (R) sling in a prospective clinical study. In all, 11 patients were lost to follow-up. A total of 17 patients (13.5%) had additional adjuvant radiotherapy before sling implantation. Before and after sling implantation, a standardized 1-h pad test was performed and post-void residual urine, uroflowmetry, quality-of-life scores and the International Index of Erectile Function (IIEF-5) were assessed. When calculating the cure and improvement rates, 'cure' was defined as no pad use or one dry prophylactic pad; and 'improved' was defined as 1-2 pads or reduction of pads >= 50%. RESULTS After a median (range) follow-up of 27 (20-37) months, and a mean follow-up of 27.2 months, the success rate was 75.4% with 51.6% 'cured' and 23.8% 'improved'. Overall daily pad use, urine loss in the 1-h pad test and quality-of-life scores improved significantly after sling implantation. Compared with 1-year follow-up data, no worsening over time was noticed and no additional complications were seen. CONCLUSION With a mid-term follow-up, the retroluminar transobturator male sling is an effective, safe and attractive treatment option for SUI after radical prostatectomy. Results are stable over time.