In a nutshell
This study compared the outcomes of transobturator and retropubic Argus male sling (T-AMS and R-AMS) in men with urinary incontinence. Researchers suggested that R-AMS is associated with lower incontinence rates and better outcomes in these patients.
Some background
About 25 million people have urinary incontinence in the US. Of that, 5 million are men. Procedures such as prostate surgery may cause stress urinary incontinence in male patients. This affects the quality of life of these patients and their daily activities. Urinary incontinence consists of uncontrolled leakage of urine. This can happen due to an overactive bladder or poor closure of the bladder (stress incontinence).
Different invasive treatments can be offered to these patients, including fixed male slings. These consist of using mesh-like tape to move the urethra (the tube that passes urine out from the bladder) into a new position. R-AMS consists of an open surgery procedure to apply slings whereas T-AMS is a less invasive method. In T-AMS slings are applied through a small body opening. This method allows for re-adjusting after the procedure. To date, there is no study comparing the outcomes associated with these two methods.
Methods & findings
This study included information about 106 patients with urinary incontinence. Of these, 74 underwent R-AMS and 32 underwent T-AMS. The average follow-up time was 44 months.
R-AMS was associated with reduced urine loss after surgery when compared to T-AMS. Dry rates were 33.3% for R-AMS and 11.8% for T-AMS. However, T-AMS was not confirmed to be a factor for decreased success.
No severe side effects were seen. Groin pain was higher in the T-AMS group. Explantation (remove tissue from the affected area for analysis) rates were also higher for T-AMS (23.3%) when compared to R-AMS (14%). Longer device survival was seen for the R-AMS group.
The bottom line
This study suggested that the classical R-AMS approach is associated with lower rates of urinary incontinence.
The fine print
The study sample was low. Larger studies are needed for stronger evidence.
Published By :
Neurourology and urodynamics
Date :
Mar 03, 2020
