Open Access

ARTICLE

AdVance male sling in irradiated patients with stress urinary incontinence

Jack M. Zuckerman, Britton Tisdale, Kurt McCammon

Department of Urology, Eastern Virginia Medical School, Norfolk, Virginia, USA
Address correspondence to Dr. Kurt McCammon, Department of Urology, Eastern Virginia Medical School, 6333 Center Drive, Norfolk, VA 23502 USA

Canadian Journal of Urology 2011, 18(6), 6013-6017.

Abstract

Introduction: This study aims to evaluate the complication rate and efficacy of the AdVance sling (American Medical Systems, Minnetonka, MN, USA) in patients with stress urinary incontinence (SUI) and a history of pelvic radiation.
Materials and methods: A retrospective chart review was conducted of all men at our institution with a history of prostate cancer and subsequent radiation therapy who were treated with an AdVance sling for SUI.
Results: Between 2007 and 2009, the AdVance sling procedure was performed in 27 patients with prior pelvic radiation therapy. The mean patient age was 73.2 years. At an average follow-up of 15.8 months, 19 patients (70%) reported benefit from the operation. The average preoperative and postoperative pad use per day was 4.2 and 1.1, respectively. One patient experienced worsening symptoms, and two reported no change. Intraoperative complications occurred in two patients (7.4%), both involving urethral injuries during needle passage; these were primarily repaired, and the procedures were completed successfully. Early complications included one urinary tract infection and one case of urinary retention requiring intermittent catheterization. Two late complications were observed: continued retention in the previously mentioned patient and hematuria (with negative cystoscopy) in one of the patients with intraoperative urethral injury. No mesh erosions or infections were reported. Nine patients (38%) experienced some decrease in efficacy over time, and four underwent subsequent incontinence procedures.
Conclusions: The AdVance male sling can be safely and effectively performed in men with a prior history of radiation therapy. Our results are encouraging; however, long-term follow-up is necessary, especially considering the decreased efficacy observed in 38% of patients.

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