The transobturator suburethral sling: a safe and effective option for all degrees of post prostatectomy urinary incontinence

التفاصيل البيبلوغرافية
العنوان: The transobturator suburethral sling: a safe and effective option for all degrees of post prostatectomy urinary incontinence
المؤلفون: John F, Sullivan, Paul N, Stassen, Diarmuid, Moran, Eva M, Bolton, Lisa G, Smyth, Cliodhna M, Browne, James C, Forde, Raanan, Tal, Thomas H, Lynch
المصدر: The Canadian journal of urology. 25(2)
سنة النشر: 2018
مصطلحات موضوعية: Aged, 80 and over, Male, Postoperative Care, Prostatectomy, Reoperation, Suburethral Slings, Urinary Incontinence, Stress, Age Factors, Middle Aged, Risk Assessment, Severity of Illness Index, Cohort Studies, Urodynamics, Treatment Outcome, Quality of Life, Humans, Aged, Follow-Up Studies, Retrospective Studies
الوصف: Male stress urinary incontinence (SUI) after radical prostatectomy (RP) is common. The surgical standard of care traditionally has been placement of an artificial urinary sphincter (AUS) but since its introduction the transobturator male sling has been shown to have particular unique advantages. Our aim was to assess outcomes of a consecutive series of suburethral sling insertions in men presenting with all degrees of post RP SUI.A consecutive cohort of men undergoing AdVance sling insertion following RP were studied. Parameters assessed included pre and postoperative urinary function, 24 hour pad use, quality of life (QoL) outcomes, complications and further treatments. Degree of incontinence was categorized as mild (1-2), moderate (3-5) or severe (≥ 6) depending on daily pad use. Patients were reviewed at 1, 4 and 6 months. The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) was used to assess symptom severity and QoL outcomes.Seventy-seven patients were included, mean age 68 and mean time to sling post RP 34 (8-113) months. Preoperative degree of incontinence: mild 22%, moderate 58%, severe 20%. Fourteen percent had undergone post RP radiation therapy (RT). In total 73% experienced complete resolution of symptoms post sling, 12% significant improvement, 15% no reduction in pad use. Sixty percent with severe incontinence were classified as cured (no pad or 1 dry pad for security reasons). When patients with preoperative RT were excluded, cure rate rose to 82%. On follow up survey at 30 months (mean), the ICIQ-SF score decreased from baseline 17.7 (9-21.0) to 8.0 (0-20) (p0.0001), CI 95% (8-12).Suburethral slings are effective and safe for all degrees of post RP incontinence, are associated with improved QoL parameters and with appropriate selection and counseling are a viable option for more severe degrees of post RP SUI.
تدمد: 1195-9479
URL الوصول: https://explore.openaire.eu/search/publication?articleId=pmid________::028f7cc26916777e3fa2f7b9629b3457
https://pubmed.ncbi.nlm.nih.gov/29680005
رقم الانضمام: edsair.pmid..........028f7cc26916777e3fa2f7b9629b3457
قاعدة البيانات: OpenAIRE