Department of Urology, Ludwig-Maximilian-University, Munich, Germany.
Urology. 2011 Feb;77(2):474-9. doi: 10.1016/j.urology.2010.07.541. Epub 2010 Dec 16.
To prospectively evaluate the efficacy of the functional AdVance transobturator sling for the treatment of male stress urinary incontinence (SUI) in patients after radical prostatectomy and additional adjuvant radiotherapy.
Between February 2007 and November 2008, 24 patients with postprostatectomy SUI (ICS grade 2-4) and additional adjuvant radiotherapy were treated consecutively with the AdVance sling. Preoperatively, intensive workup, including urodynamic assessment and flexible urethroscopy, was performed. Physical examinations (pad test, uroflowmetry, ultrasound) and questionnaires (I-QOL score, ICIQ-UI-SF score) were performed during baseline and during follow-up. Cure rate was defined as no pad use or one dry pad, and improved rate as 1-2 pads or reduction of pads by ≥50%.
After a median follow-up of 18.0 months (range 12-33 months, mean 18.8 months), the success rate was 50%. Daily pad use and pad weight in the 1-hour pad test decreased significantly. Patients with ICS grade 2 SUI exhibited a trend for a better success rate in comparison with patients with grade 3 and 4 SUI. Results were durable over time. Postoperatively, 16.7% of the patients exhibited transient acute urinary retention which resolved without further treatment after a maximum of 6 weeks. 1 sling had to be removed because of initial misplacement.
In selected patients after adjuvant radiotherapy, the AdVance sling achieved a success rate of 50% and results were stable in a median follow-up of 18 months. Complication rates were low and comparable to complication rates for patients without additional radiotherapy.
前瞻性评估功能性 Advance 经闭孔吊带治疗根治性前列腺切除术后合并辅助放疗的男性压力性尿失禁（SUI）的疗效。
2007 年 2 月至 2008 年 11 月，连续 24 例根治性前列腺切除术后合并辅助放疗的 SUI（ICS 分级 2-4 级）患者接受 Advance 吊带治疗。术前进行了包括尿动力学评估和软性尿道镜检查在内的强化检查。在基线和随访期间进行体格检查（垫试验、尿流率、超声）和问卷调查（I-QOL 评分、ICIQ-UI-SF 评分）。治愈定义为不使用垫或使用 1 个干垫，改善定义为使用 1-2 个垫或垫减少≥50%。
中位随访 18.0 个月（范围 12-33 个月，平均 18.8 个月）后，成功率为 50%。每日垫使用量和 1 小时垫试验中的垫重量显著减少。与 ICS 分级 3 和 4 的 SUI 患者相比，ICS 分级 2 的 SUI 患者的成功率有改善趋势。结果随时间推移保持稳定。术后，16.7%的患者出现短暂性急性尿潴留，最多 6 周后无需进一步治疗即可缓解。1 例吊带因最初位置不当而被取出。
在接受辅助放疗的选择患者中，Advance 吊带的成功率为 50%，中位随访 18 个月时结果稳定。并发症发生率低，与未接受额外放疗的患者的并发症发生率相当。
