Adjustable Perineal Male Sling for the Treatment of Urinary Incontinence;Long Term Results

To present the long-term results in patients with urinary incontinence who were treated with adjustable perineal male sling.

An adjustable male sling procedure was performed in 45 patients with a mean age of 67. 6±7.8 years who had urinary incontinence. The mean period between primary prostatic surgery and the sling procedure was 36.7 months. The difference between the classical sling and the adjustable one is a 10 cm tissue expander between the two layers of polypropylene mesh with an injection port. Adjustment of the sling was performed with saline via this port, in case of recurrence or persistence of incontinence.

Mean follow-up was 48±29 months. Average operative time was 101.1±25.5 min (45-150). Median daily pad use in these patients decreased from 8(2-12) to 1(0-10)(p<0.001). During long-term follow-up 37.8% used zero pads daily, 28.9% used 1 to 2 pads daily, making the total success rate 66.7%. Complete dry rate was higher in patients with non-severe incontinence compared to the others with severe incontinence (57.9% 23.1%, p=0.029). Nevertheless; there was no significant difference in the case of total success rate (%78.9 vs 57.7%, respectively; p=0.135). Age was significantly greater in both complete dry group (71.1±4.8 vs 65.4±8.7) and total success group (70.1±5.2 vs 62.4±5.2) (p=0.017, p<0.001, respectively).

Adjustable male sling is an acceptable procedure with low complication rates especially in patients with mild and moderate incontinence. At the same time, this procedure may be offered to patients with previous incontinence surgery.

Urology. 2017 May 02 [Epub ahead of print]

Mesut Altan, Tariq Asi, Cenk Yucel Bilen, Ali Ergen

Urology resident Hacettepe University School of Medicine, Department of Urology, Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, 06100, Sıhhıye, Ankara, Türkiye, Mobile: +90 555 865 8193.. Electronic address: ., Urology resident Hacettepe University School of Medicine, Department of Urology, Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, 06100, Sıhhıye, Ankara, Türkiye. Electronic address: ., Professor of Urology Hacettepe University School of Medicine, Department of Urology, Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, 06100, Sıhhıye, Ankara, Türkiye, Mobile: +90 5335568442.. Electronic address: ., Professor of Urology Hacettepe University School of Medicine, Department of Urology, Hacettepe Üniversitesi Hastaneleri, Erişkin Hastanesi, B Katı Üroloji Anabilim Dalı, 06100, Sıhhıye, Ankara, Türkiye, Mobile: +90 532 286 6530.. Electronic address: .

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