Open Access

ARTICLE

AdVance sling use decreasing relative to artifcial urinary sphincters

Chad R. Pusateri, Jack M. Zuckerman

Department of Urology, Naval Medical Center San Diego, San Diego, California, USA
Address correspondence to Dr. Jack Zuckerman, Department of Urology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA32134 USA

Canadian Journal of Urology 2017, 24(6), 9121-9125.

Abstract

Introduction: To evaluate the percent of AdVance male slingusagerelativetoartifcialurinarysphincters(AUS) overa9yearperiodsinceitsintroductioninordertoassess trends across the United States.
Materials and methods: As a surrogate for procedures performed, we reviewed device utilization trends of the AdVance sling and AUS broken down by American Urological Association (AUA) section. ANOVA testing between years was used to determine purchasing trends withpvaluesof<0.05consideredstatisticallysignifcant.
Results: Relative to AUS, AdVance sling percentage signifcantly increased from 36% in 2007 to 48% in 2008 (p = 0.032). Sling percentage then remained stable over the next 3 years from 2008-2011 with no signifcant percent change between years (p = NS). Compared with 2008-2011, AdVance usage decreased in 2012 to 29% (p = 0.002) and remained stable at this decreased relative level through 2015 (p = NS, difference between years 2012-2015). Comparing incontinence procedures across AUAsections,theSoutheastsectionperformedthehighest percentageofmalestressurinaryincontinenceprocedures, including 27% of all AdVance slings and 25% of all artifcial sphincters.
Conclusion:ProportionofAdVanceslingusagerelative to AUS increased after its introduction through 2008. Usage remained stable at an increased level for the next 3years.MorerecentyearshavefounddecreasedAdVance usageandaresurgenceoftheartifcialurinarysphincter. Reasons for these trends remain speculative.

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