Pre-operative predictors of outcome following male sling implant for post prostatectomy incontinence
BAUS ePoster online library. Toia B. 06/25/19; 259570; P7-6
Bogdan Toia
Bogdan Toia
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Abstract
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INTRODUCTION

The male sling is an alternative to the artificial urinary sphincter for the treatment of post prostatectomy incontinence, with variable success rates reported. The likelihood of success is not well understood and the predictors of outcome poorly documented. We looked at the pre-operative parameters that might facilitate patient selection

Patients and methods

All men with post prostatectomy incontinence had data collected in prospective database. Data included previous intervention, radiotherapy, 24h pad weights and urodynamic parameters including retrograde leak point pressure.

RESULTS

100 men were treated with the Advance male sling system between 2012 and 2018. 73 patients were cured of their incontinence (1 or less pads for reassurance) whilst 27 patients remained significantly wet.

The table shows preoperative parameters in those who were dry versus those remaining wet. Differences were assessed using paired T-tests, Mann-Whitney U Test and Fisher's Exact Test as appropriate. A p<0.05 is considered significant

Male sling was successful in 73% of patients, of which 46% did not use any pads. Only 27% of patients had residual leakage. The only significant predictors were number of pads, detrusor overactivity and bladder capacity.

Conclusions

Male sling was a successful treatment in the majority of patients irrespective of pre-operative parameters. The only predictors of significance were number of pads, detrusor overactivity and capacity on preoperative videourodynamics. Patients should be carefully counselled but not be excluded from male sling treatment on pre operative parameters alone.

INTRODUCTION

The male sling is an alternative to the artificial urinary sphincter for the treatment of post prostatectomy incontinence, with variable success rates reported. The likelihood of success is not well understood and the predictors of outcome poorly documented. We looked at the pre-operative parameters that might facilitate patient selection

Patients and methods

All men with post prostatectomy incontinence had data collected in prospective database. Data included previous intervention, radiotherapy, 24h pad weights and urodynamic parameters including retrograde leak point pressure.

RESULTS

100 men were treated with the Advance male sling system between 2012 and 2018. 73 patients were cured of their incontinence (1 or less pads for reassurance) whilst 27 patients remained significantly wet.

The table shows preoperative parameters in those who were dry versus those remaining wet. Differences were assessed using paired T-tests, Mann-Whitney U Test and Fisher's Exact Test as appropriate. A p<0.05 is considered significant

Male sling was successful in 73% of patients, of which 46% did not use any pads. Only 27% of patients had residual leakage. The only significant predictors were number of pads, detrusor overactivity and bladder capacity.

Conclusions

Male sling was a successful treatment in the majority of patients irrespective of pre-operative parameters. The only predictors of significance were number of pads, detrusor overactivity and capacity on preoperative videourodynamics. Patients should be carefully counselled but not be excluded from male sling treatment on pre operative parameters alone.

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