Introduction

In recent years, several studies showed the effectiveness and safety of the AdVance sling for the treatment of male stress urinary incontinence (SUI). In 2010 the second generation of Advance, the AdVance XP was introduced. Aim of the study was to evaluate the efficacy and safety of the AdVance XP sling in male SUI after radical prostatectomy in a prospective multicenter study.

Methods

In total 115 patients were included. Patients with urine nocturnal incontinence, previous incontinence surgery, previous radiotherapy and coaptive zone <1cm in the preoperative repositioning test were excluded. Postoperatively, a standardized 24-hour-pad test, quality of life scores (IQOL and ICIQ-UI SF), VAS for pain, IIEF5, IPSS and PGI-score were performed. All patients with 0-5g in the pad test were defined as cured and improved with a reduction of urine loss >50%. All others were classified as failures. Significance analysis was performed with the help of Wilcoxon-test.

Results

Mean preoperative urine loss in the 24h pad-test was 272.0 g (median 272.0 g). _x000D_ After a follow-up of 3 months (n= 114) 64.9% of the patients were cured and 31.6% improved. Mean urine loss decreased significantly to 34.9 g (p<.001). After a follow-up of 24 months (n= 80) 68.8% of the patients were cured and 22.5% improved. Mean urine loss decreased significantly to 19.1 g (p<.001). After a follow-up of 36 months (n= 47) 66.0% of the patients were cured and 23.4% improved. Mean urine loss decreased significantly to 21.8 g (p<.001). After a follow-up of 48 months (n= 15) 60.0% of the patients were cured and 20% improved. Mean urine loss decreased significantly to 21.8 g (p<.001). There were no lost to follow-up._x000D_ Overall patients reported of no relevant pain (mean VAS: 0.5) and the patients´ satisfaction was high (mean PGI: 1.5). Mean I-QoL and ICIQ-UI SF improved significantly (p<.001, respectively) at maximum follow-up. There were no significant postoperative changes in IIEF5 and IPSS. No intraoperative and no long-term complications occurred. No erosion or explanations occurred._x000D_

Conclusions

The AdVance XP shows good and stable effectiveness and low complication rates even in a mid-term follow-up of up to 4 years. Our results though highlight the importance of adequate preoperative patient selection.

Funding

None.