The male perineal sling: intermediate-term results

Neurourol Urodyn. 2005;24(7):648-53. doi: 10.1002/nau.20166.

Abstract

Aims: In men with stress urinary incontinence (SUI) due to sphincteric incompetence, surgical options include periurethral injection of bulking agents, implantation of an artificial urinary sphincter (AUS), and sling surgery. Short-term results of the male sling have generally been favorable. We report the intermediate-term results of the bone-anchored male perineal sling with a median of 4 years and minimum of 2 years follow-up.

Methods: From March 2000 to April 2003, 48 patients (average age = 68 years) underwent male sling surgery. Patients were evaluated pre-operatively and post-operatively via history, physical examination, pad score, and administration of the incontinence section of the UCLA/RAND prostate cancer index (PCI).

Results: Pre-operatively all patients rated their incontinence as severe, and used >or=3 pads daily. Median follow-up was 48 months (range = 24-60). Average pad usage decreased from 4.6 +/- 2.1 pads per day to 1.0 +/- 1.7 pads per day (P < 0.01). Median UCLA PCI incontinence score increased from 63-343 (P < 0.01). Overall, 31/48 patient (65%) were cured of their leakage (no problem, no pads), 7/48 (15%) were much improved (small problem, 1 pad), 3/48 (6%) were mildly improved (moderate problem, 2 pads daily), and 7/48 (15%) failed (big problem, >or=3 pads).

Conclusions: Intermediate-term results for the male sling demonstrate a success rate comparable to that of the AUS (80% <or= 1 pad daily). This technique has established a very low morbidity, and is a reliable alternative to AUS surgery for the treatment of male SUI.

MeSH terms

  • Aged
  • Bone Screws
  • Follow-Up Studies
  • Humans
  • Male
  • Perineum
  • Postoperative Complications / surgery*
  • Prostatectomy*
  • Prostatic Neoplasms / surgery
  • Surgical Mesh
  • Treatment Outcome
  • Urinary Incontinence, Stress / surgery*
  • Urologic Surgical Procedures