Open Access

ARTICLE

Virtue male sling outcomes and application to a contemporary nomogram

David Abramowitz¹, Andre-Philippe Sam², Mark Pachorek³, Jim Shen¹, Nora Ruel⁴, Jonathan N. Warner¹

1 Department of Surgery, Division of Urology, City of Hope Medical Center, Duarte, California, USA
2 University of California at Riverside, Riverside, California, USA
3 Pasadena City College, Pasadena, California, USA
4 Department of Biostatistics, City of Hope Medical Center, Duarte, California, USA
Address correspondence to Dr. David Abramowitz, Department of Surgery, Division of Urology, City of Hope Medical Center, 1500 East Duarte Road, Duarte, CA 91010 USA

Canadian Journal of Urology 2021, 28(2), 10625-10630.

Abstract

Introduction: To report outcomes of our Virtue male sling series and evaluate predictors of surgical success and failure. We also retrofit the Male Stress Incontinence Grading Scale (MSIGS) refined nomogram, including the standing cough test (SCT), to assess its application to our cohort.
Materials and methods: A retrospective review was completed at a single institution over a 4-year period of all Virtue male slings implanted for stress urinary incontinence (SUI). Patient demographics including pad usage per day (PPD) and MSIGS were obtained on all patients after their bladders were filled cystoscopically. Failure was defined as >1 PPD and/or conversion to another anti-incontinence procedure. Incidence, management, and outcomes of complications were also evaluated.
Results: Forty-six men who underwent Virtue male sling at a median follow-up of 15.6 months were analyzed with an objective success rate of 78% and a subjective success rate of 85%. Preoperative predictors of surgical success were ability to stop stream on physical exam, lack of total incontinence, and no history of posterior urethral stricture. MSIGS alone was not predictive of sling success or failure. Penile numbness occurred in 11% of patients and reoperation with incision of the sutured together transobturator arms improved sensation in all patients.
Conclusion: Virtue male sling has high objective and subjective success rates with a manageable side effect profile. Evidence of residual sphincteric function appears to be more predictive of sling success rather than MSIGS.

---

Keywords

---