Long-term follow-up of the AdVance(®)/AdVanceXP(®) sling. What are the surgeons' impressions? What are the patients'?

To analyse the safety, efficacy and quality of life of patients with male stress urinary incontinence after radical prostatectomy treated with the AdVance(®) and AdvanceXP(®) slings.

The study included 92 patients with stress urinary incontinence after radical prostatectomy treated with the AdVance(®) and AdVanceXP(®) sling between May 2008 and December 2015. A perineal repositioning test was performed in all cases with sphincter coaptation of≥1.5cm. Mild stress urinary incontinence was defined as the use of 1-2 absorbers/24h; moderate was defined as 3-5 absorbers/24h; and severe was defined as more than 5 absorbers/24h. Healing was defined as the total absence of using pads; improvement was defined as a reduction>50% in the number of pads; and failure was defined as a reduction<50, no improvement or worsened incontinence. Check-ups were conducted at 3, 12 and 36 months after the surgery. We employed the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) for the quality of life index. The complications are listed according to the Clavien-Dindo classification.

The degree of preoperative incontinence was mild in 23.9%, moderate in 67.4% and severe in 8.7% of the patients. The mean use of preoperative pads was 3.1 (range 1-6, 95% CI). The mean preoperative ICIQ-SF score was 16.5 (15-20). Sphincter coaptation≥1.5cm using the perineal repositioning test was present in 87 patients (94.6%). The mean follow-up from insertion of the sling was 42.1 months. Some 89.1% of the patients were healed at 3 months, 70.7% were healed at 12 months, and 70.4% were healed at 36 months. The ICIQ-SF score at 3, 12 and 36 months showed significant improvement (P<.001) compared with the preoperative score.

The Advance(®) and AdvanceXP(®) system are effective over time in terms of urinary continence and patient satisfaction.

Actas urologicas espanolas. 2017 Nov 10 [Epub ahead of print]

A Romero Hoyuela, L Reina Alcaina, E Izquierdo Morejon, A Rosino Sanchez, C Carrillo George, A Rivero Guerra, I Barcelo Bayonas, A Pardo Martinez, V Muñoz Guillermo, B Pietricica, T Fernandez Aparicio, G Hita Villaplana, B Miñana Lopez

Servicio de Urología, Hospital Universitario Morales Meseguer, Murcia, España. Electronic address: ., Servicio de Urología, Hospital Universitario Morales Meseguer, Murcia, España.

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