Professional paper
https://doi.org/10.20471/acc.2018.57.s1.12
Transobturator Advance® Sling Suspension for the Treatment of Postprostatectomy Stress Urinary Incontinence
Goran Štimac
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Borislav Spajić
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Alek Popović
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Danijel Justinić
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Igor Grubišić
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Šoip Šoipi
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ivan Svaguša
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Matea Pirša
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Boris Ružić
; Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Abstract
Stress urinary incontinence (SUI) continues to present a major complication after radical prostatectomy. Suburethral slings represent one of the less invasive options for postprostatectomy SUI, and a more recent addition is a transobturator sling, the AdVance®. We report our results with the AdVance® sling for the management of postoperative SUI. The evaluation was conducted on 47 patients with AdVance® implant for SUI in our institution (November 2010 - June 2017). Measurements included age, etiology of SUI, duration of SUI, follow-up and pad use per day (PPD) pre- and postoperatively. Patients were classified as cured if they used no pads or 1 PPD for security reasons, or as improved if 1-2 PPDs were used and if there was a 50% reduction in pad use per day postoperatively. In our series we observed a reduction of mean PPD of 5.1 (2-8) to 1.7 (0-4) postoperatively. After follow-up and according to our criteria, the cure rate was 51.1% (24/47) and the improvement rate 27.5% (13/47). The overall success rate was 78.6% (37/47). No improvement was observed in 21.4% (10/47) of patients. Failure rates after sling placement for patients with additional treatments following prostatectomy were much higher (60% (3/10) for radiation therapy and 66.7% (4/10) for urethral stricture disease). Our results show favourable cure and improvement rates and are comparable to results from larger series. The most appropriate candidates for the AdVance® sling are patients with mild to moderate postprostatectomy SUI. The results may be even better in patients without additional treatment following prostatectomy, such as radiation therapy or surgery for stricture disease.
Keywords
Prostate cancer; Urinary incontinence; Postprostatectomy incontinence; Stress urinary incontinence; Suburethral sling; Transobturator sling
Hrčak ID:
207904
URI
Publication date:
1.10.2018.
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