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36‐month data for the AdVance XP® male sling: results of a prospective multicentre study

BJU international, 2017-04, Vol.119 (4), p.626-630 [Peer Reviewed Journal]

2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd ;2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd. ;ISSN: 1464-4096 ;EISSN: 1464-410X ;DOI: 10.1111/bju.13704 ;PMID: 27862836 ;CODEN: BJINFO

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Title:
36‐month data for the AdVance XP® male sling: results of a prospective multicentre study
Author: Bauer, Ricarda M. ; Grabbert, Markus T. ; Klehr, Benedikt ; Gebhartl, Peter ; Gozzi, Christian ; Homberg, Roland ; May, Florian ; Rehder, Peter ; Stief, Christian G. ; Kretschmer, Alexander
Subjects: AdVance XP ; Aged ; Aged, 80 and over ; efficacy ; Equipment Design ; Humans ; Incontinence ; Male ; male sling ; Middle Aged ; Postoperative Complications - physiopathology ; Postoperative Complications - surgery ; post‐prostatectomy incontinence ; Prospective Studies ; Prostatectomy - adverse effects ; Prostatic Neoplasms - physiopathology ; Prostatic Neoplasms - surgery ; Quality of Life ; radical prostatectomy ; safety ; Suburethral Slings ; Treatment Outcome ; Urinary Incontinence, Stress - etiology ; Urinary Incontinence, Stress - physiopathology ; Urinary Incontinence, Stress - surgery ; Urine
Is Part Of: BJU international, 2017-04, Vol.119 (4), p.626-630
Description: Objectives To evaluate the efficacy and safety of the AdVance XP® sling (Boston Scientific, formerly American Medical Systems) in male stress urinary incontinence (SUI) after radical prostatectomy in a prospective multicentre study, as in recent years several studies have shown the effectiveness and safety of the AdVance sling for treating male SUI and in 2010 the second‐generation AdVance XP was introduced with several changes in the sling design and a new needle shape. Patients and Methods In all, 115 patients were included. Patients with nocturnal UI, previous UI surgery, previous radiotherapy and a coaptive zone of <1 cm in the preoperative repositioning test were excluded. Postoperatively, a standardised 24‐h pad test, quality‐of‐life scores [International Quality of Life score (IQOL) and International Consultation on Incontinence Questionnaire short form (ICIQ‐UI SF)], visual analogue scale (VAS) for pain, five‐item version of the International Index of Erectile Function (IIEF‐5), International Prostate Symptom Score (IPSS) and Patient Global Impression of Improvement (PGI‐I) score, were performed. All patients with a 0–5 g pad test were defined as cured and improved with a reduction of urine loss of >50%. All others were classified as failures. Significance analysis was performed using the Wilcoxon test. Results The mean (median) preoperative urine loss in the 24‐h pad test was 272.0 (272.0) g. After a follow‐up of 3 months (114 patients), 64.9% of the patients were cured and 31.6% had an improved continence status. The mean urine loss decreased significantly to 34.9 g (P < 0.001), with a mean VAS score of 0.5, and mean PGI‐I of 1.5. After a follow‐up of 24 months (80 patients), 68.8% of the patients were cured and 22.5% had improved. The mean urine loss decreased significantly to 19.1 g (P < 0.001), with a mean VAS score of 0.3, and mean PGI‐I of 1.5. After a follow‐up of 36 months (47 patients), 66.0% of the patients were cured and 23.4% had improved. The mean urine loss decreased significantly to 21.8 g (P < 0.001), with a mean VAS score of 0.0, and mean PGI‐I of 1.6. The mean IQOL and ICIQ‐UI SF improved significantly (both P < 0.001) after 36 months. There were no significant postoperative changes in IIEF‐5 and IPSS. No intraoperative and no long‐term complications occurred. No erosion or explanations occurred. Conclusion The AdVance XP shows good and stable effectiveness and low complication rates even at a mid‐term follow‐up of up to 36 months.
Publisher: England: Wiley Subscription Services, Inc
Language: English
Identifier: ISSN: 1464-4096
EISSN: 1464-410X
DOI: 10.1111/bju.13704
PMID: 27862836
CODEN: BJINFO
Source: MEDLINE
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36‐month data for the AdVance XP® male sling: results of a prospective multicentre study

2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd ;2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd. ;ISSN: 1464-4096 ;EISSN: 1464-410X ;DOI: 10.1111/bju.13704 ;PMID: 27862836 ;CODEN: BJINFO

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