Two years on: TOMS male slings

This study examined the long-term effectiveness of the TOMS male sling in treating urinary incontinence following prostate surgery.

While urinary symptoms initially improved with the TOMS male sling, researchers concluded that some degree of incontinence can occur after the first year of treatment.

Urinary incontinence is common among men undergoing prostate surgery. A previous study, following men one-year after surgery, found the TOMS transobturator male sling to be an effective treatment option. Sling procedures are minimally invasive and involve the placement of a small sling to lift the urethra to its normal position. The aim of this study was to evaluate the long-term effectiveness and safety of TOMS in treating urinary incontinence after prostate surgery.

A total of 40 men with persistent urinary incontinence due to prostate surgery were included in this study. All men were treated with the TOMS sling, and treatment outcomes were followed for two years.

Overall, urinary symptoms were improved following the TOMS procedure. Number of pads required on a daily basis, episodes of stress incontinence and quality of life were all significantly improved six months after the procedure, when compared to before treatment. This improvement was largely maintained at two-year follow-up.

However, urinary symptoms related to an overactive bladder appeared to worsen over time. Seven men (18%) required additional surgical treatment between the first and the second year after TOMS procedure. Of the remaining 33 men included in the two-year follow-up, about half (46%) no longer required pads for urinary incontinence. No complications associated with the TOMS procedure were noted during the follow-up period. 

The researchers concluded that the TOMS male sling is a safe and effective treatment for urinary incontinence following prostate surgery. However, TOMS is associated with a tendency toward impaired continence after the first year of treatment. 

Larger clinical trials are needed to investigate the long-term effectiveness of male slings.