To assess the tolerance and midterm clinical outcomes regarding the treatment of post-prostatectomy male incontinence (PPI) with a new four arm mesh sling.
This is a French multicentre prospective study for the treatment of PPI, which included 93 patients, subjected to radical prostatectomy at least a year before sling implantation.
Data was collected preoperatively, and patients were followed at 3, 12 and 24 months post operatively. Objective outcome parameters included number of pads per day, 24h pad-test, maximum urinary flow rate (Qmax) and urinary retention. We further analysed the Urinary Symptom Profile (USP(®) ) score, the degree of erectile dysfunction, the patients' satisfaction level, post-operative pain, and procedure complications. Catheterisation and hospitalisation periods were also registered. Patients were considered cured if no protection was used and/or daily pad weight
Average hospitalisation period was 1. 57±0. 70 days. All patients remained catheterised for 1. 17±0. 48 days. On an intention to treat analysis, at 24 months, 34. 41% were cured, 27. 10% had improved, and 19. 35% were considered failures. Two patients experienced transient urinary retention. USP(®) questionnaire scores showed a significant decrease in incontinence and hyperactive bladder. There was a non significant tendency for reduced severe erectile dysfunction (ED), and a shift towards moderate ED was observed. No severe complications occurred.
The Surgimesh M-SLING(®) transobturator and prepubic four arm urethral sling represents an easy-to-deploy, safe and durable therapeutic alternative for mild to moderate post-prostatectomy incontinence. Its implantation did not have a negative influence on sexual performance outcomes. This article is protected by copyright. All rights reserved.
BJU international. 2015 Oct 24 [Epub ahead of print]
B Le Portz, O Haillot, M Brouziyne, C Saussine
Hôpital PrivéOcéane, Vannes, France. , C. H. R. U Bretonneau, Tours, France. , Centre National des Sports Mouly Rachid, Rabat, Maroc. , CHU Strasbourg-Hôpital Civil, Strasbourg, France.