New Male Sling Procedure In Men With Stress Urinary Incontinence

September 23, 2007 – 8:17 pm | posted in Urology / Nephrology

UroToday.com - Presented Tuesday, 04 September 2007 at the 29th Congress of the Societe International d’Urologie - SIU 2007 - Optimizing Clinical Outcomes in Prostate and Renal Cell Carcinomas - The Second Annual Symposium on Advanced GU Malignancy - Palais des Congres de Paris, France

Introduction: Sling procedures have been described as a treatment option for post prostatectomy urinary incontinence. This is a report of preliminary results of a new male sling procedure (without bone anchors) for treatment of urinary stress incontinence occurring after prostate surgery.

Methods: Between January 2005 and December 2006, 16 patients underwent a male sling procedure (without bone anchoring system) for treatment of urinary stress incontinence following prostate surgery. The procedure is performed with the patient in the lithotomy position using a perineal approach. A polypropylene mesh was placed over the bulbar portion of the urethra and tied to the periost of the ischio pubic ramus with nylon sutures; adjusting sling tension to a compression pressure of 60 cm. water (The retrograde leak point pressure was maintained at 60 cm. water). The evaluation of the severity of the incontinence was based on physical examination and number of pads used per day.

Results: After a median follow up of 6 months, 11 patients were dry, 4 patients had significant improvement and 1 who had previously severe incontinence, showed no improvement. Operative time was 30 to 80 minutes (mean 50). No intraoperative complications were recorded. The catheter was removed after 1 to 3 days (mean 1.8). All patients who were dry or had improvments were satisfied and presented no obstructive or irritative urinary disorders. No cases of pubic pain, osteitis or urethral erosion were reported.

Conclusion: Our modification of the male sling procedure has satisfactory results like the original technique. This new procedure appears to be safe, efficacious and low cost.

Authors: Hidoussi A, Jaidane M, Slama A, Youssef A, Kalel Y, Ben Sorba N, Mosbah AF

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