Intermediate-term results, up to 4 years, of a bone-anchored male perineal sling for treating male stress urinary incontinence after prostate surgery

Abstract

Objective: To examine the intermediate-term outcome (up to 4 years) of a bone-anchored perineal sling (InVance(TM), American Medical Systems, Minnetonka, MN, USA) in men with stress urinary incontinence (SUI) after prostate surgery.

Patients and methods: In all, 62 men with SUI were implanted with the InVance sling. SUI was diagnosed after radical prostatectomy in 58 patients and after benign prostatic hyperplasia (BPH) prostatectomy in four patients. Implantation of the InVance bone-anchored bulbourethral sling was conducted primarily under spinal anaesthesia. Patients were considered cured, if they stopped wearing continence pads and improved if the daily number of pads used decreased by at least half. The Incontinence Quality of Life questionnaire and a simple verbal question about patient satisfaction with the surgery were also used and complications were measured.

Results: In all, 40 patients (65%) were cured and 14 (23%) were improved after a mean follow-up of 28 months. The UI cure rates at 3 and 4 years follow-up were 70% and 66%, respectively. The most common side-effect was transient scrotal or perineal pain or numbness, which affected 12 patients (19%). There was a prolonged postvoid residual urine volume of >100 mL in six patients (10%), which resolved within 2 weeks of indwelling catheterization. Explantation of the sling was required in two cases (3%) because of infection. In one patient (2%), revision was required for bone-anchor dislodgement.

Conclusion: The InVance sling offers good intermediate-term cure and improvement rates for SUI after prostatectomy. The procedure has an acceptably low rate of minor complications, and should be considered for treating men with less severe forms (< or =5 pads per day) of SUI.