[Treatment of postoperative male urinary incontinence by INVANCE prosthesis: preliminary results].

PURPOSE

To evaluate the preliminary results of treatment of postoperative male stress urinary incontinence (SUI) by the INVANCE (AMS) suburethral sling.

MATERIAL AND METHODS

From June 2003 to May 2004, 22 patients with stress urinary incontinence secondary to prostatic surgery (13 radical prostatectomies, 7 Ablatherm, 2 transurethral resections of the prostate) were treated by INVANCE sling. The patients presented either grade 1 incontinence (1 to 2 pads per day), or grade 2 incontinence (3 to 4 pads per day), or grade 3 incontinence (5 or more pads per day). The INVANCE process uses a rectangular polyester sling positioned under the bulbar urethra via a perineal incision. It is attached to the 2 ischiopubic rami by 3 titanium screws using a disposable electric screwdriver. Patients were reviewed every 3 months to evaluate the results (continence, Qmax, post-voiding residual volume, IPSS score, quality of life)

RESULTS

The mean duration of the procedure was 79 minutes (range: 60-120). No intraoperative incidents were observed. The bladder catheter was removed on D1 (n=20) or D2 (n=2). The mean length of stay was 3.3 days (range: 2-8). Complications consisted of perineal haematoma (n=1), acute urinary retention after catheter removal (n=4), sling infection requiring removal (n=1), and prolonged perineal pain (n=5). No de novo irritative or obstructive urinary tract disorders were observed. With a median follow-up of 12 weeks (range: 3-44), 11 patients were completely continent (50%), 5 patients were significantly improved (22.7%) and 6 patients were considered to be failures (27.3%), 3 of whom had previously received external beam radiotherapy.

CONCLUSION

The INVANCE process appears to be a simple and effective option for the treatment of grade 1 and 2 postoperative male stress urinary incontinence.