Mid‐term outcomes of a male retro‐urethral, transobturator synthetic sling for treatment of post‐prostatectomy incontinence: Impact of radiotherapy and storage dysfunction

Purpose To determine mid‐term durability of the AdVance sling for post‐prostatectomy incontinence (PPI) and impact of prior radiotherapy and storage dysfunction. Method Eighty men undergoing AdVance sling for PPI during 2008–2013 were reviewed. Pre‐op urodynamics, pre and post‐op pad usage, prior ra...

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Bibliographic Details
Published in:Neurourology and urodynamics 2017-04, Vol.36 (4), p.1147-1150
Main Authors: Habashy, David, Losco, Giovanni, Tse, Vincent, Collins, Ruth, Chan, Lewis
Format: Article
Language:English
Subjects:
AdVance sling
Aged
Aged, 80 and over
Cancer surgery
detrusor overactivity
Humans
incontinence
Incontinence Pads
Male
Middle Aged
Prostate cancer
Prostatectomy
Prostatectomy - adverse effects
Prostatic Neoplasms - complications
Prostatic Neoplasms - radiotherapy
Prostatic Neoplasms - surgery
Prostatic Neoplasms - therapy
Prosthesis Implantation
Radiation therapy
radiotherapy
Radiotherapy - adverse effects
Reviews
Suburethral Slings
Treatment Outcome
Urinary bladder
Urinary Bladder, Overactive - complications
Urinary Bladder, Overactive - physiopathology
Urinary Incontinence, Stress - etiology
Urinary Incontinence, Stress - physiopathology
Urinary Incontinence, Stress - surgery
Urodynamics
Urological surgery
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Summary:Purpose To determine mid‐term durability of the AdVance sling for post‐prostatectomy incontinence (PPI) and impact of prior radiotherapy and storage dysfunction. Method Eighty men undergoing AdVance sling for PPI during 2008–2013 were reviewed. Pre‐op urodynamics, pre and post‐op pad usage, prior radiotherapy, and PGI‐I scores were recorded. Result Mean follow‐up was 36 months (range 14–72). Twelve men had radiotherapy pre‐op, 10 had detrusor overactivity (DO), and 20 reduced compliance. Pre‐op mean 24‐hr pad weight was 264 g and mean pads‐per‐day (PPD) 2.60 ± 0.29. In the early post‐op period (3–6 months), mean PPD was 0.40 (SD 0.16); at mid‐term follow‐up mean PPD was 1.02 ± 0.31. Radiotherapy and DO were independently predictive of poor mid‐term outcome. Men with DO or radiotherapy were using 1.03 ± 0.42 (P = 0.019) and 1.17 ± 0.41 (P = 0.02) more PPD, respectively than men without these factors. At mid‐term follow‐up, men without radiotherapy or DO were using 1.98 ± 0.28 less PPD compared to pre‐operatively (P 
ISSN:0733-2467
1520-6777
DOI:10.1002/nau.23078