Postoperative male stress urinary incontinence: Outcomes of treatment by I-STOP TOMS® transobturator sling

Objective. - To evaluate the outcome of postoperative male stress urinary incontinence surgery using the I-STOP TOMS sub-urethral sling. Material and method. Between April 2007 and August 2012, 29 patients had been treated by sub-urethral sling. Stress urinary incontinence was classified as mild, moderate or severe according to the number of pads per day. Patients were also assessed thanks to IQOL, MHU and Ditrovie self-administered questionnaires. Results. - Before surgery, 16 patients (55.2%) had mild incontinence, 12 (41.4%) had moderate incontinence and one (3.4%) had severe incontinence. Preoperative median MHU was 9 (5-12); median IQOL was 73 (58-88); and median Ditrovie was 2.7 (2.1-3.3). Three months after surgery, median MHU was 7 (4-9); median IQOL was 85 (75-99); and median Ditrovie was 2.1 (1.6-2.4). Pre- and postoperative questionnaires scores show a significant improvement for IQOL (P = 0.014) and Ditrovie (P < 0.001). After 3 months, six patients were dry (20.7%), 19 patients had mild incontinence (65.5%) and four had moderate incontinence (13.8%); in resume 17 patients (58.6%) showed a significant improvement in the number of pads (20.7% dry, 37.9% improved). After a mean follow-up of 24 19.9 months, five patients were dry (17.2%), 20 patients (69%) had mild incontinence and four had moderate incontinence (13.8%). Conclusion. - I-STOP TOMS sub-urethral sling improved the level of postoperative stress urinary incontinence. However, the continence rate was weak. Level of evidence. - 5. (C) 2013 Elsevier Masson SAS. All rights reserved.