Sling Surgery for the Treatment of Urinary Incontinence after Transurethral Resection of the Prostate: New Data on the Virtue Male Sling and an Evaluation of Literature

To provide a review of literature regarding the role of male slings in the treatment of stress urinary incontinence (SUI) following a transurethral resection of the prostate (TURP) and to evaluate the effects of the Virtue male sling in patients suffering from post TURP SUI.

A systematic review of literature was performed to identify all papers on the use of male slings in patients suffering from post TURP SUI. Secondly a prospective cohort study was conducted on 8 patients that received the Virtue as surgical treatment of post TURP SUI. Questionnaires were collected preoperatively and 1, 3, 6, 12 months postoperatively. Success and improvement were defined as pad usage (0 pads: success, pad reduction of ≥50%: improvement). Primary endpoint was the continence rate 1 year postoperatively. Data was analyzed using paired the two-tailed t-test.

Sling surgery appears to be significantly less successful in the treatment of SUI in post TURP patients compared to other types of prostate surgery. The clinical trial on the Virtue sling observed continence in 4/8 patients, with another 2 patients with improved continence after 1 year follow-up. No difference in success was observed between patients suffering from mild or severe SUI.

Little is currently known about the effects of sling surgery in patients suffering from mild to severe SUI following a TURP. Although the Virtue male sling seems to be an efficient and safe device in the treatment of this complication, longer follow-up and larger cohorts will be needed to further confirm these results.

Urology. 2016 Oct 20 [Epub ahead of print]

Cornelis R C Hogewoning, Louise A M Meij, Rob C M Pelger, Hein Putter, Esmée M Krouwel, Henk W Elzevier

Department of Urology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: ., Department of Urology, Leiden University Medical Center, Leiden, The Netherlands., Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.