Long-Term Follow-up of Polypropylene Bone Anchored Slings

Introduction The transvaginal bone anchored polypropylene sling (BAS) has proven to be a successful treatment for patients with SUI. However, there is limited data on long-term outcomes following BAS with polypropylene mesh. We report our series of patients who had at least 3 years of follow-up after placement of BAS. Materials and Methods A retrospective review of prospectively collected data of patients undergoing BAS for stress urinary incontinence (SUI) with minimum 3 year follow-up was performed. Outcomes and complications were determined from annual mailed post-operative questionnaires. Results 142 patients who had undergone BAS and had answered post-operative questionnaires at a minimum of 3 years were identified. Average follow-up was 58 months (range 36-97 months). The overall success rate was 71% with a dry rate of 27%. Complications occurred in 9% of patients, more commonly in patients without a history of anti-incontinence procedure. Conclusions Although less commonly used, BAS with polypropylene mesh is associated with an acceptable success rate at long term follow-up but a low completely dry rate. .

Botulinum toxin injection: a review of injection principles and protocols

Despite the favorable outcomes seen using botulinum toxin (BTX) for voiding dysfunction using BTX, a standardized technique and protocol for toxin injection is not defined. We reviewed the current literature on intravesical BTX injection for DO (detrusor overactivity). Specific attention was placed on defining optimal injection protocol, including dose, volume, and injection sites. In addition, we sought to describe a standard technique to BTX injection.

Surgical technique using AdVance™ Sling placement in the treatment of post-prostatectomy urinary incontinence

OBJECTIVES: To describe and illustrate a new minimally invasive approach to the treatment of male stress urinary incontinence following prostatectomy. SURGICAL TECHNIQUE: Our initial experience consisted of four patients treated with the Advance sling for post-prostatectomy urinary incontinence. Sling placement involves the following steps: 1. Urethral dissection and mobilization, 2. Identification of surgical landmarks, 3. Placement of needle passers through the obturator foramen, 4. Mesh advancement, 5. Mesh tensioning and fixation, 6. Incision closure. COMMENTS: Based on our initial experience, we believe that the Advance Male Sling System may be a safe technique for the treatment of male stress urinary incontinence. This technique is easy to perform and may offer a reproducible, transobturator approach. Further patient accrual is ongoing to assess the safety and reproducibility of this technique. Also, additional study will focus on efficacy standards and complication rates.