Adjustable bulbourethral male sling: Experience after 30 cases of moderate to severe male stress urinary incontinence
Objective: To report our experience using the Argus perineal sling from July 2015 to April 2018 for male stress urinary incontinence (SUI) after prostatic surgery. To evaluate the safety, efficacy and healthrelated quality of life in patients undergoing this procedure. Patients and methods: The posi...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2020-04-01
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| Series: | Archivio Italiano di Urologia e Andrologia |
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| Online Access: | https://www.pagepressjournals.org/index.php/aiua/article/view/8458 |
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| author | Michele Cotugno Daniel Martens Giacomo Pirola Martina Maggi Carmelo Destro Pastizzaro Michele Potenzoni Bernardo Cesare Maria Rocco Salvatore Micali Andrea Prati |
| author_facet | Michele Cotugno Daniel Martens Giacomo Pirola Martina Maggi Carmelo Destro Pastizzaro Michele Potenzoni Bernardo Cesare Maria Rocco Salvatore Micali Andrea Prati |
| author_sort | Michele Cotugno |
| collection | DOAJ |
| description | Objective: To report our experience using the Argus perineal sling from July 2015 to April 2018 for male stress urinary incontinence (SUI) after prostatic surgery. To evaluate the safety, efficacy and healthrelated quality of life in patients undergoing this procedure. Patients and methods: The positioning of an adjustable bulbourethral male sling provides a perineal incision, exposure of the bulbospongiosus muscle and the application of the sling bearing on it with transobturator passage of the two extremities with out-in technique. To modulate the bearing tension on the urethra, with a rigid cystoscope the Retrogade Leak Point Pressure is measured, increasing it by 10-15 cm of H20 from baseline. We retrospectively evaluated the results of this implant performed by the same operator on 30 patients who presented post-operative SUI from medium to severe (> = 2 pads/day, pad test at one hour > = 11 g). Mean operative time and possible intra and postoperative complications were evaluated. Postoperatively each patient was reassessed according to the following parameters: number of pads consumed/ die, pad tesy at one hour, ICQS-F, any related side effects.
Results: After the intervention, 21 of 30 patients (70% of the total) were totally continent (< 1 pad / day, pad test at 1 h < 1-2 g, ICQS-F < 11), out of them 4 required a single adjustment at 3 months in order to achieve this result. 9 of 30 patients (30 %) achieved a clinically significant improvement without obtaining total continence (mean reduction of the n° pads/day: -2.5 ± 1 DS; average reduction of the pad test at 1 h: -20 g ± 4 DS; ICQS-F average reduction: -6 points ± 2 DS), out of them 5 required a 3 month adjustment to obtain these improvements resulting, 4 needed 2 adjustments resulting because the first adjustment was not satisfactory and one who ameliorated from severe to moderate incontinence decided to live in this clinical condition.
Conclusions: The results of our study show that the positioning of this sling represents a valid treatment for the moderate and severe post-surgical male SUI. The possibility of adjusting the tension of the sleeve in a "second look" makes the intervention adaptable according to the results obtained. Only multicentric clinical trials on larger series would clarify and eventually confirm the clinical benefits of this sling in post-surgical male SUI. |
| first_indexed | 2024-12-10T18:40:19Z |
| format | Article |
| id | doaj.art-c08da64ae07f4afcadac9bae36d61347 |
| institution | Directory Open Access Journal |
| issn | 1124-3562 2282-4197 |
| language | English |
| last_indexed | 2024-12-10T18:40:19Z |
| publishDate | 2020-04-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Archivio Italiano di Urologia e Andrologia |
| spelling | doaj.art-c08da64ae07f4afcadac9bae36d613472022-12-22T01:37:41ZengPAGEPress PublicationsArchivio Italiano di Urologia e Andrologia1124-35622282-41972020-04-0192110.4081/aiua.2020.1.7Adjustable bulbourethral male sling: Experience after 30 cases of moderate to severe male stress urinary incontinenceMichele Cotugno0Daniel Martens1Giacomo Pirola2Martina Maggi3Carmelo Destro Pastizzaro4Michele Potenzoni5Bernardo Cesare Maria Rocco6Salvatore Micali7Andrea Prati8Dipartimento Chirurgico, U.O. di Urologia, Ospedale di Vaio-Fidenza, FidenzaDipartimento Chirurgico, U.O. di Urologia, Ospedale di Vaio-Fidenza, FidenzaDipartimento di Chirurgia Generale e Specialistica, U.O.C Urologia, Ospedale di ArezzoDipartimento di Chirurgia Generale e Specialistica, U.O.C Urologia, Ospedale di ArezzoDipartimento Chirurgico, U.O. di Urologia, Ospedale di Vaio-Fidenza, FidenzaDipartimento Chirurgico, U.O. di Urologia, Ospedale di Vaio-Fidenza, FidenzaDipartimento di Chirurgia Generale e Specialità Chirurgiche, U.O di Urologia, Azienda Ospedaliero-Universitaria di ModenaDipartimento di Chirurgia Generale e Specialità Chirurgiche, U.O di Urologia, Azienda Ospedaliero-Universitaria di ModenaDipartimento Chirurgico, U.O. di Urologia, Ospedale di Vaio-Fidenza, FidenzaObjective: To report our experience using the Argus perineal sling from July 2015 to April 2018 for male stress urinary incontinence (SUI) after prostatic surgery. To evaluate the safety, efficacy and healthrelated quality of life in patients undergoing this procedure. Patients and methods: The positioning of an adjustable bulbourethral male sling provides a perineal incision, exposure of the bulbospongiosus muscle and the application of the sling bearing on it with transobturator passage of the two extremities with out-in technique. To modulate the bearing tension on the urethra, with a rigid cystoscope the Retrogade Leak Point Pressure is measured, increasing it by 10-15 cm of H20 from baseline. We retrospectively evaluated the results of this implant performed by the same operator on 30 patients who presented post-operative SUI from medium to severe (> = 2 pads/day, pad test at one hour > = 11 g). Mean operative time and possible intra and postoperative complications were evaluated. Postoperatively each patient was reassessed according to the following parameters: number of pads consumed/ die, pad tesy at one hour, ICQS-F, any related side effects. Results: After the intervention, 21 of 30 patients (70% of the total) were totally continent (< 1 pad / day, pad test at 1 h < 1-2 g, ICQS-F < 11), out of them 4 required a single adjustment at 3 months in order to achieve this result. 9 of 30 patients (30 %) achieved a clinically significant improvement without obtaining total continence (mean reduction of the n° pads/day: -2.5 ± 1 DS; average reduction of the pad test at 1 h: -20 g ± 4 DS; ICQS-F average reduction: -6 points ± 2 DS), out of them 5 required a 3 month adjustment to obtain these improvements resulting, 4 needed 2 adjustments resulting because the first adjustment was not satisfactory and one who ameliorated from severe to moderate incontinence decided to live in this clinical condition. Conclusions: The results of our study show that the positioning of this sling represents a valid treatment for the moderate and severe post-surgical male SUI. The possibility of adjusting the tension of the sleeve in a "second look" makes the intervention adaptable according to the results obtained. Only multicentric clinical trials on larger series would clarify and eventually confirm the clinical benefits of this sling in post-surgical male SUI.https://www.pagepressjournals.org/index.php/aiua/article/view/8458SlingProstatectomyMale stress urinary incontinence |
| spellingShingle | Michele Cotugno Daniel Martens Giacomo Pirola Martina Maggi Carmelo Destro Pastizzaro Michele Potenzoni Bernardo Cesare Maria Rocco Salvatore Micali Andrea Prati Adjustable bulbourethral male sling: Experience after 30 cases of moderate to severe male stress urinary incontinence Archivio Italiano di Urologia e Andrologia Sling Prostatectomy Male stress urinary incontinence |
| title | Adjustable bulbourethral male sling: Experience after 30 cases of moderate to severe male stress urinary incontinence |
| title_full | Adjustable bulbourethral male sling: Experience after 30 cases of moderate to severe male stress urinary incontinence |
| title_fullStr | Adjustable bulbourethral male sling: Experience after 30 cases of moderate to severe male stress urinary incontinence |
| title_full_unstemmed | Adjustable bulbourethral male sling: Experience after 30 cases of moderate to severe male stress urinary incontinence |
| title_short | Adjustable bulbourethral male sling: Experience after 30 cases of moderate to severe male stress urinary incontinence |
| title_sort | adjustable bulbourethral male sling experience after 30 cases of moderate to severe male stress urinary incontinence |
| topic | Sling Prostatectomy Male stress urinary incontinence |
| url | https://www.pagepressjournals.org/index.php/aiua/article/view/8458 |
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