The surgery is associated with subjective and objective improvements in urinary continence.

The findings are based on a study of 22 men with stress urinary incontinence whose voiding abilities were assessed before and after undergoing the perineal sling procedure. The average follow-up period was 25 months.

Preoperatively, urine leakage was rated as a big problem by 15 men and as a moderate problem by 7, Dr. Nathan F. E. Ullrich and Dr. Craig V. Comiter, from the University of Arizona Health Science Center in Tucson, note. After surgery, three patients rated urine leakage as a big problem, three as a moderate problem, and the remainder described it as being little or no problem.

This subjective improvement coincided with a drop in pad use (p < 0.01) and with an improvement in urinary function score (p < 0.001). Moreover, mean retrograde leak point pressure (RLPP) increased with surgery.

None of the patients developed bladder outlet obstruction, the authors state. Similarly, testing revealed no significant adverse changes in urodynamics.

Detruser overactivity was noted in 2 of 5 patients with moderate or big leakage problems, the report indicates. In both cases, more than 3 pads per day were needed and the postoperative RLPP was less than 50 cm of water.

The results suggest that the male sling procedure is an effective treatment for stress urinary incontinence that does not induce bladder outlet obstruction, the investigators conclude.

J Urol 2004;172:204-206.

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