Long-term Success Durability of Transobturator Male Sling.

To determine the long-term outcome of transobturator sling for male Stress Urinary Incontinence (SUI) clustered according to pre-operative SUI severity, and to identify predictors of treatment success durability and failure occurrence in long-term follow-up.

A non-concurrent study was conducted on all transobturator male sling cases performed from August 2006 to June 2012 by a single surgeon. Pre-operative SUI severity was clustered into mild (≤2 ppd), moderate (3-4 ppd) or severe (≥5 ppd). Success was defined as complete dryness with zero pads used (cured), and a patient with ≥50% improvement, satisfied without further procedures needed. Otherwise it was considered a treatment failure. Clinical variables significantly associated with long-term treatment success were determined. Time-to-event (Kaplan-Meier) and Multiple-Cox regression analysis were performed to determine predictors of long-term treatment outcome.

A total of 215 patients (mild-59, moderate-94, severe-62) with a mean follow-up of 56.4±41.6 months were included. On long-term follow-up, 150 (69.8%) patients-maintained treatment success and 96 (44.7%) were dry. The long-term outcome success clustered according to SUI severity as mild, moderate and severe was 84.7%, 72.3%, and 51.6%, respectively. Kaplan-Meier with Log-rank test and Multiple Cox-regression determined that both concomitant urge incontinence and pre-operative SUI severity were independent predictors of long-term durability of treatment success and failure occurrence. Pre-operative SUI severity was the only predictor of long-term cure sustainability.

The time to event analysis with an average of ∼5 years post-operative follow-up has determined that the pre-operative severity and presence of concomitant urge incontinence were independent predictors for long-term outcome.

Urology. 2019 Aug 08 [Epub ahead of print]

Michael E Chua, Jack Zuckerman, James Bradley Mason, Jessica DeLong, Ramón Virasoro, Jeremy Tonkin, Kurt A McCammon

Department of Urology, Eastern Virginia Medical School, Norfolk, VA, USA; Institute of Urology, St. Luke's Medical Center, NCR, Manila, Philippines. Electronic address: ., Department of Urology, Naval Medical Center Portsmouth. Electronic address: ., Department of Urology, Eastern Virginia Medical School, Norfolk, VA, USA. Electronic address: ., Department of Urology, Eastern Virginia Medical School, Norfolk, VA, USA. Electronic address: ., Department of Urology, Eastern Virginia Medical School, Norfolk, VA, USA. Electronic address: ., Department of Urology, Eastern Virginia Medical School, Norfolk, VA, USA. Electronic address: ., Department of Urology, Eastern Virginia Medical School, Norfolk, VA, USA. Electronic address: .

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