Blayne K Welk1, Sender Herschorn. 1. Division of Urology, Sunnybrook Hospital, University of Toronto, Toronto, Ontario, Canada.
Abstract
PURPOSE OF REVIEW: Stress incontinence in men is still a common problem after surgical treatment of prostatic disease. This article reviews the techniques and results of recently described surgical slings available to treat male stress incontinence. RECENT FINDINGS: Medium-term follow-up (mean 3-4 years) of patients treated with bone-anchored slings has been recently published, suggesting a success rate (cured or improved) of 70-80%. Short-term follow-up (mean of 6-12 months) of transobturator retrourethral slings demonstrates a success rate of 62-83%. Novel sling designs include mechanisms to manipulate the tension postoperatively and inside-out transobturator trocar passage. Common complications associated with slings are acute urinary retention and perineal pain. Rare complications include urethral erosion and infection. Retropubic approaches are associated with a risk of bladder perforation. SUMMARY: Male slings are a valid option for treating male stress incontinence, and do offer several advantages over the artificial urinary sphincter. However, long-term data and multicenter series are needed in order to compare directly with the artificial urinary sphincter.
PURPOSE OF REVIEW: Stress incontinence in men is still a common problem after surgical treatment of prostatic disease. This article reviews the techniques and results of recently described surgical slings available to treat male stress incontinence. RECENT FINDINGS: Medium-term follow-up (mean 3-4 years) of patients treated with bone-anchored slings has been recently published, suggesting a success rate (cured or improved) of 70-80%. Short-term follow-up (mean of 6-12 months) of transobturator retrourethral slings demonstrates a success rate of 62-83%. Novel sling designs include mechanisms to manipulate the tension postoperatively and inside-out transobturator trocar passage. Common complications associated with slings are acute urinary retention and perineal pain. Rare complications include urethral erosion and infection. Retropubic approaches are associated with a risk of bladder perforation. SUMMARY: Male slings are a valid option for treating male stress incontinence, and do offer several advantages over the artificial urinary sphincter. However, long-term data and multicenter series are needed in order to compare directly with the artificial urinary sphincter.
Authors: Mathieu Bettez; Le Mai Tu; Kevin Carlson; Jacques Corcos; Jerzy Gajewski; Martine Jolivet; Greg Bailly Journal: Can Urol Assoc J Date: 2012-10 Impact factor: 1.862
Authors: M Horstmann; H John; K Horton; N Graf; C Reischauer; A Doert; K Hergan; A Gutzeit Journal: Int Urol Nephrol Date: 2013-06-18 Impact factor: 2.370