Ricarda M Bauer1, Christian Gozzi2, Benedikt Klehr3, Alexander Kretschmer3, Markus Grabbert3, Peter Rehder4, Florian May5, Christian G Stief3, Peter Gebhartl6, Roland Homberg7. 1. Department of Urology, Ludwig-Maximilians-University, Marchioninistr. 15, Campus Grosshadern, 81377, Munich, Germany. Ricarda.Bauer@med.uni-muenchen.de. 2. Department of Urology, Marienklinik, Bolzano, Italy. 3. Department of Urology, Ludwig-Maximilians-University, Marchioninistr. 15, Campus Grosshadern, 81377, Munich, Germany. 4. Department of Urology, Medical University, Innsbruck, Austria. 5. Helios Amper Klinik Dachau, Department of Urology, Ludwig-Maximilians-University Teaching Hospital, Dachau, Germany. 6. Department of Urology, LKH Voecklabruck, Voecklabruck, Austria. 7. Urology, St. Josef-Krankenhaus, Hamm, Germany.
Abstract
PURPOSE: For the treatment of persistent post-prostatectomy incontinence (PPI), several surgical treatment options including male slings are available. In 2010, the second generation of the retrourethral male sling Advance, AdVanceXP, was introduced. Aim of the study was to examine in a prospective multicentre study the outcome of AdVanceXP in the treatment of PPI. METHODS: Ninety-four patients were treated with AdVanceXP. Patients with nocturnal incontinence, previous incontinence surgery, with coaptive zone <1 cm and irradiated patients were excluded. Measurements included: daily pad usage, 24-h pad weight test, post-operative pain in the visual analogue scale, International Quality of Life questionnaire, International Consultation on Incontinence Questionnaire short form, IEEF5 and Patient Global Impression of Improvement. Adverse events were recorded. All patients with no pads and 0-5 g in the 24-h pad test were defined as cured and those with a reduction in urine loss >50 % as improved. RESULTS: Preoperatively, the median 24-h pad weight test was 274 g and daily pad usage was 3. At 1-year follow-up, 66.3 % of patients could be classified as cured and 25.3 % as improved. After 2 years, 73.1 % could be classified as cured and 19.6 % as improved. Urine loss decreased (p < 0.001), and quality of life improved significantly (p < 0.001). Mean PGI was 1.5 after 1 year and 1.4 after 2 years. Majority of complications were minor. No intraoperative complications and five serious post-operative events occurred (grade IIIB complications). No explantation was necessary. CONCLUSIONS: AdVanceXP, when correctly indicated, shows good effectiveness and low complication rates after up to 2 years.
PURPOSE: For the treatment of persistent post-prostatectomy incontinence (PPI), several surgical treatment options including male slings are available. In 2010, the second generation of the retrourethral male sling Advance, AdVanceXP, was introduced. Aim of the study was to examine in a prospective multicentre study the outcome of AdVanceXP in the treatment of PPI. METHODS: Ninety-four patients were treated with AdVanceXP. Patients with nocturnal incontinence, previous incontinence surgery, with coaptive zone <1 cm and irradiated patients were excluded. Measurements included: daily pad usage, 24-h pad weight test, post-operative pain in the visual analogue scale, International Quality of Life questionnaire, International Consultation on Incontinence Questionnaire short form, IEEF5 and Patient Global Impression of Improvement. Adverse events were recorded. All patients with no pads and 0-5 g in the 24-h pad test were defined as cured and those with a reduction in urine loss >50 % as improved. RESULTS: Preoperatively, the median 24-h pad weight test was 274 g and daily pad usage was 3. At 1-year follow-up, 66.3 % of patients could be classified as cured and 25.3 % as improved. After 2 years, 73.1 % could be classified as cured and 19.6 % as improved. Urine loss decreased (p < 0.001), and quality of life improved significantly (p < 0.001). Mean PGI was 1.5 after 1 year and 1.4 after 2 years. Majority of complications were minor. No intraoperative complications and five serious post-operative events occurred (grade IIIB complications). No explantation was necessary. CONCLUSIONS: AdVanceXP, when correctly indicated, shows good effectiveness and low complication rates after up to 2 years.
Entities:
Keywords:
AdVanceXP; Complications; Male sling; Post-prostatectomy incontinence; Quality of life; Retrourethral sling
Authors: Donald M Bushnell; Mona L Martin; Kent H Summers; Jan Svihra; Christos Lionis; Donald L Patrick Journal: Qual Life Res Date: 2005-10 Impact factor: 4.147
Authors: Alexander Kretschmer; Alexander Buchner; Benedikt Leitl; Markus Grabbert; Anne Sommer; Wael Khoder; Christian Gozzi; Christian G Stief; Ricarda M Bauer Journal: Int Neurourol J Date: 2016-12-26 Impact factor: 2.835