Research progress of urethral sling in the treatment of male urinary incontinence after prostatectomy / 现代泌尿外科杂志

Stress urinary incontinence (SUI) following prostatectomy is an important and common problem in male, which can significantly reduce the quality of life. Urethral sling is a promising treatment for male SUI. It is easy to operate and can avoid the insertion of prosthesis, making it highly acceptable to patients. In recent years, with the advancement of technology, several kinds of slings have been put into clinical application and have achieved great outcomes. This article reviews the application of urethral sling in the treatment of SUI after prostatectomy.

Artificial Urinary Sphincter for Postradical Prostatectomy Urinary Incontinence — Is It the Best Option? / 대한배뇨장애요실금학회지

Male stress urinary incontinence (SUI) can undoubtedly reduce quality of life and promote personal distress and psychosocial alienation. The frequency of postprostatectomy urinary incontinence (PPI) counts on the characterization of urinary incontinence and the periods of patient follow-up. Operational therapeutics, for instance, urethral male slings and artificial urinary sphincters, are well-chosen as adequate and secure surgeries for male SUI in men with continual PPI when conservative treatment is ineffective. Over the former 2 decades, surgery has progressed regarding both operative approach and sling architecture. However, there are no guidelines about when surgery should be carried out and which is the most appropriate surgical option. In this review, we summarize recent advances in implantable devices for PPI and also discuss traditional surgical care. When we are planning the male PPI surgery, careful preoperative work-up should be performed and surgical method should be chosen according to the severity of the disease. Male sling is preferred in mild and moderate symptomatic patients with normal detrusor pressure and it is recommended to select traditional artificial urinary sphincter device in those with severe symptoms. It is expected that effective devices without adverse events will be developed with technical advances in near future.

Initial 4 Cases Experience of Male Sling Procedure for the Treatment in Patients with Post-prostatectomy Incontinence

There are 3 surgical treatments for the management of post-prostatectomy incontinence, including endoscopic injection of periurethral bulking agent, perineal sling procedure, and artificial urinary sphincter (AUS). 4 patients with post-prostatectomy incontinence in our hospital underwent sling procedure using polypropylene mesh. All patients were evaluated for urodynamic result, pad count, operative time, hospital stay, complication, success, and satisfaction. Mean age was 67.8years (64-75). Mean follow-up time was 38.5months (30-51). 2 patients underwent radical prostatectomy, and other 2 patients underwent transurethral prostatectomy. Of the 4 patients, 3 (75%) were successful. In satisfaction, 2 (50%) were unsatisfied due to recurrent incontinence and erectile dysfunction. The male sling procedure using polypropylene mesh is a simple, effective treatment and an additional therapeutic option.