Male Urinary Sling – Simple Outpatient Fix for Post- Prostatectomy Incontinence

Men with prostate cancer live in fear that surgery or radiation will induce incontinence. Recent review confirms a simple outpatient mesh sling easily works 62-80% of time to cure situation.

Curr Opin Urol. 2010 Sep 9. [Epub ahead of print]
Are male slings for postprostatectomy incontinence a valid option?
Welk BK, Herschorn S.
Division of Urology, Sunnybrook Hospital, University of Toronto, Toronto, Ontario, Canada.

This canadian review states

“RECENT FINDINGS: Medium-term follow-up (mean 3-4 years) of patients treated with bone-anchored slings has been recently published, suggesting a success rate (cured or improved) of 70-80%. Short-term follow-up (mean of 6-12 months) of transobturator retrourethral slings demonstrates a success rate of 62-83%. Novel sling designs include mechanisms to manipulate the tension postoperatively and inside-out transobturator trocar passage”

“Complications include mesh infection, de-novo detrusor overactivity (which can be managed with anticholinergics), elevated postvoid residual (which usually resolves with short period of catheterization), and perineal pain, which is temporized with non-narcotic analgesics and resolves in 2–3 months”.

This is well studied – I have included the list of studies here”                                                                                                                                                    CURED

Comment – Incontinence should not be a major issue in prostate cancer with such a simple procedure available.

addendum:

Eur Urol. 2011 Nov 12. [Epub ahead of print]
The Inside-Out Transobturator Male Sling for the Surgical Treatment of Stress Urinary Incontinence After Radical Prostatectomy: Midterm Results of a
Single-Center Prospective Study.
Leruth J, Waltregny D, de Leval J.  abstract here

  • 49% were cured, 35% improved, and 16% not improved
  • obesity and prior radiation adversely effects results

 

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