Efficacy and safety of the Advance® procedure in treatment of moderate stress urinary incontinence after radical prostatectomy. Preliminary results on 21 patients

The objectives of the study were to evaluate the efficacy and safety of the Advance (R) procedure, using a transobturator tape, in the treatment of male urinary stress incontinence after radical prostatectomy. Twenty-one consecutive patients (60 to 77 years old), operated between September 2007 and March 2008, were included in this monocentric prospective study. The Advance (R) system is a minimally invasive procedure marked by AMS. in which a polypropylene tape is placed underneath the bulbomembranous urethra via a transobturator route (outside - in procedure). The time between radical prostatectomy and the Advance (R) procedure range from 10 to 100 months (39.4). Most patients (20/21) presented moderate urinary incontinence (3 to 4 pads/day). Only one patient had severe urinary incontinence (> 4 pads/day). No patient had leakage at rest. The mean time of the procedure was 45 minutes (range 30 to 70). No perioperative complications were observed. The three months postoperative evaluation showed improvement in 17 patients (80%) with seven patients completely dry (33%) and six patients significantly improved (mild urinary incontinence (28.5%). The four other patients improved with moderate incontinence and treatment was ineffective on four patients. No patient had any postoperative complications. Especially, there were no dysuria, evaluated by max flow rate and residual volume. In conclusion, these preliminary results show, with a short follow-up, that Advance (R) procedure seems to be an efficient, simple and well-tolerated procedure. To cite this journal: Pelvi-Perineologie 5 (2010).