Outcomes of the adjustable male sling at 3 years

This study followed men who were treated with an adjustable male sling procedure for stress urinary incontinence (SUI). Researchers concluded that the adjustable male sling is safe and effective, particularly in men with mild to moderate SUI.

Urinary incontinence is common among men undergoing prostate surgery. It has been estimated that 25 to 69% of men experience SUI after prostate surgery. SUI can significantly affect quality of life and surgical intervention for SUI is often needed. Sling procedures are a less invasive alternative to artificial urinary sphincters. A common technique involves the placement of a valve near the urethra. This valve is then filled with saline after surgery in order to adjust the position of the urethra as needed. More studies are needed to examine the long-term effectiveness of the adjustable male sling procedure.

The aim of this study was to assess long-term outcomes of male slings in treating SUI.

45 men who underwent the adjustable male sling procedure for SUI were included. 60% of men had severe SUI. 28.9% of men had undergone previous surgery for incontinence. The average time since prostate surgery was 36.7 months. Treatment outcomes were followed for an average of 48 months.

The average number of incontinence pads used per day decreased from 8 to 1. The treatment success rate at follow-up was 66.7% (based on incontinence pad use). 37.8% of men used no incontinence pads and 28.9% used 1 to 2 pads per day. Treatment success rate was not affected by previous incontinence surgery.

Complete continence was achieved in 57.9% of men with non-severe SUI. It was significantly lower for men with severe SUI (23.1%). However, severity of SUI did not significantly affect total success rate.

The average procedure time was 101.1 minutes. No complications occurred during the procedure. One case of wound infection was successfully treated with antibiotics. Another patient required surgical revision due to infection at 9 months. 4 patients had urinary retention (an inability to pass urine) and received a catheter (flexible tube inserted into the bladder to drain urine). No cases of device erosion or device failure were noted. The average number of adjustments was 2.

The procedure failed in 15 patients (33.3%). Of these, 4 requested for the sling to be removed without additional incontinence surgery. An artificial urinary sphincter was placed in 2 patients. Another adjustable male sling operation was done to 4 patients, 2 of them had improving results. No intervention was done to the remaining 5 patients.

Researchers concluded that the adjustable male sling is safe and effective, particularly in men with mild to moderate SUI. The authors suggested that this procedure could be offered to men with previous incontinence surgery.

Larger studies that randomly assign patients to treatment groups are needed to confirm the long-term effectiveness of adjustable male slings.