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Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons
57th Annual Meeting Abstracts


Poster 26

Abstract Title

Initial Experience with the AdVance Male Urethral Sling 

 

Author Block

Stephen Eyre, MD
Urology Practice Associates,Needham, MA

 

Abstract Body

Background: The AdVance  Male Urethral Sling (American Medical Systems) is a minimally invasive procedure for treating mild to moderate urinary incontinence (defined as <5 pads per day). It repositions the bulbous urethra in a more normal retropubic location. Advantages over the artificial urinary sphincter (AUS) include the lack of mechanical components that can malfunction, lack of circumferential pressure on the urethra that can lead to erosion, and the absence of any need for manipulation of a pump by the patient to achieve voiding. Methods: Twenty-three men had a sling placed between July 2007 and August 2010.  The cause of incontinence was post-prostatectomy in 21, post TURP in one, and post cystectomy with neobladder in one. The mean duration of incontinence was 5 years (range 1-20 years). 

Results: Eighteen patients are completely continent, one is significantly improved, and three have not noted any improvement. One patient suffered a traumatic urethral catheterization about one month postoperatively with a urethral perforation at the site of the sling. He required explantation of the sling.Two patients developed postoperative urinary retention requiring discharge with a urethral catheter for 2-3 days, and one patient who voided well postoperatively developed transient urinary retention following a total knee replacement several months later.
Conclusion: The AdVance male sling is a well-tolerated outpatient procedure with immediate results and minimal risk. It should be considered as first-line therapy for men with mild to moderate stress urinary incontinence.

 

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