Department of Urology, Queen Elizabeth Hospital, Birmingham, UK.
Scand J Urol. 2021 Apr;55(2):155-160. doi: 10.1080/21681805.2021.1877342. Epub 2021 Feb 1.
There is minimal data published on the longevity of the transobturator retrobulbar male sling (AdVance™). We aimed to determine the efficacy, the complication rate and need for salvage SUI surgery in the medium to long term for male sling insertion.
We performed a retrospective review of all patients undergoing male sling insertion at a single centre between 2009 and 2018. Data on patient demographics, pre and post-operative International Consultation on Continence Questionnaire - Urinary Incontinence (Short Form) (ICIQ-UI(SF)) scores and 24 h pad usage were collected. Success was calculated as a combination of the cured rate (0-1 security pad use) and the improved rate (>50% reduction in pad usage). Data was also collected on complications, patient satisfaction as well as need for further SUI surgery.
A total of 91 patients underwent male sling insertion in the period specified; median follow up was 69 months. Success rates at 3 months in mild SUI, moderate SUI and severe SUI groups were 96, 86 and 80%, respectively. In the medium to long term, this drops to 65, 62 and 47%, respectively. The overall rate of artificial urinary sphincter (AUS) implantation was 15%. Common complications included groin pain (3%), infection (3%), urinary retention (10%) and de novo overactive bladder (OAB) (11%). The only factor predicting success or failure was pre-operative ICIQ-UI(SF) score.
AdVance™ male sling success rates deteriorate from 89% at 3 months to 61% at 5 years. The risk of complications is low and, for the most part, transient. Sling insertion remains a reasonable treatment option for male patients suffering with stress urinary incontinence (SUI).
关于经闭孔尿道中段男性吊带（AdVance™）的长期效果数据很少。我们旨在确定男性吊带植入术的中远期疗效、并发症发生率和需要挽救性治疗压力性尿失禁（SUI）手术的情况。
我们对 2009 年至 2018 年间在单中心接受男性吊带植入术的所有患者进行了回顾性研究。收集了患者人口统计学数据、术前和术后国际尿控协会尿失禁问卷-尿失禁（短表）（ICIQ-UI(SF)）评分和 24 小时尿垫使用情况。成功定义为治愈率（0-1 个安全尿垫使用）和改善率（尿垫使用减少>50%）的结合。还收集了并发症、患者满意度以及是否需要进一步的 SUI 手术的数据。
在指定期间内，共有 91 例患者接受了男性吊带植入术；中位随访时间为 69 个月。轻度、中度和重度 SUI 组的 3 个月成功率分别为 96%、86%和 80%。在中远期，这一比例分别降至 65%、62%和 47%。人工尿道括约肌（AUS）植入率为 15%。常见并发症包括腹股沟疼痛（3%）、感染（3%）、尿潴留（10%）和新发逼尿肌过度活动症（OAB）（11%）。唯一预测成功或失败的因素是术前 ICIQ-UI(SF)评分。
AdVance™男性吊带的成功率从 3 个月时的 89%下降至 5 年时的 61%。并发症风险低，且在大多数情况下是短暂的。吊带植入术仍然是治疗男性压力性尿失禁（SUI）患者的合理选择。
