Management of recurrent post-prostatectomy incontinence after previous failed retrourethral male slings

Al-Najar, A., Kaufmann, S., Boy, S., Naumann, C. M., Junemann, P. K. and Horst, C. Van Der (2011) Management of recurrent post-prostatectomy incontinence after previous failed retrourethral male slings Can Urol Assoc J, 5 (2). pp. 107-11. DOI 10.5489/cuaj.10092 cuaj.10092 pii.

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Abstract

OBJECTIVE: Our objective was to establish the feasibility of combining 2 minimally invasive procedures in patients with failed primary treatment (male sling) in post-prostatectomy incontinence (PPI) patients. METHODS: From January 2007 to July 2008, 40 men with PPI were implanted with a suburethral tape (2 patients with Seratim, 3 with I-Stop and 35 with Advance). The median preoperative pad count was 4 (range 2-10). Prior to sling placement, 6 patients had undergone ProACT implantation. Of these, 4 patients required explantation due to balloon migration and 2 patients had their balloons kept in situ, with the balloons deflated. RESULTS: Twenty-five patients were socially continent at this time. Fifteen patients (37.5) did not improve or their improvement was not significant. These patients had a preoperative pad count between 7 and 10. Two of these patients had prostate adjustable continence therapy (ProACT) systems still in place. By gradually filling the balloons to 3 mL, both of these patients achieved complete continence, which was maintained at a mean follow-up of 8.5 months. Three patients with prior pelvic irradiation received an artificial urinary sphincter and achieved continence at mean follow-up of 8.3 months. The remaining 10 patients received a ProACT system in addition to the already implanted sling. After appropriate healing and filling of the balloons (average balloon volume 5 mL), all 10 patients reached complete continence; they were pad-free at a mean follow-up of 6 months (range 3-9). CONCLUSIONS: The combination of ProACT and a suburethral tape was demonstrated to be a possible treatment option in recurrent or persistent PPI.

Document Type: Article
Additional Information: Al-Najar, Amr Kaufmann, Sascha Boy, Soenke Naumann, Carsten Maik Junemann, Peter-Klaus Van Der Horst, Christof Canada Canadian Urological Association journal = Journal de l'Association des urologues du Canada Can Urol Assoc J. 2011 Apr;5(2):107-11. doi: 10.5489/cuaj.10092.
Refereed: Yes
DOI etc.: 10.5489/cuaj.10092 cuaj.10092 pii
ISSN: 1911-6470 (Print) 1911-6470 (Linking)
Date Deposited: 01 Nov 2012 04:58
Last Modified: 01 Nov 2012 04:58
URI: http://eprints.uni-kiel.de/id/eprint/16623

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