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Are male slings for post-prostatectomy incontinence a valid option?

Welk, Blayne K; Herschorn, Sender

doi: 10.1097/MOU.0b013e32833ecd09
Reconstructive surgery: Edited by Christopher R. Chapple

Purpose of review: Stress incontinence in men is still a common problem after surgical treatment of prostatic disease. This article reviews the techniques and results of recently described surgical slings available to treat male stress incontinence.

Recent findings: Medium-term follow-up (mean 3–4 years) of patients treated with bone-anchored slings has been recently published, suggesting a success rate (cured or improved) of 70–80%. Short-term follow-up (mean of 6–12 months) of transobturator retrourethral slings demonstrates a success rate of 62–83%. Novel sling designs include mechanisms to manipulate the tension postoperatively and inside-out transobturator trocar passage. Common complications associated with slings are acute urinary retention and perineal pain. Rare complications include urethral erosion and infection. Retropubic approaches are associated with a risk of bladder perforation.

Summary: Male slings are a valid option for treating male stress incontinence, and do offer several advantages over the artificial urinary sphincter. However, long-term data and multicenter series are needed in order to compare directly with the artificial urinary sphincter.

Division of Urology, Sunnybrook Hospital, University of Toronto, Toronto, Ontario, Canada

Correspondence to Dr Sender Herschorn, Division of Urology, Sunnybrook health Science Centre, 2075 Bayview Avenue, Suite #MG408, Toronto, ON M4N 3M5, Canada Tel: +1 416 480 4787; fax: +1 416 480 6121; e-mail: s.herschorn@utoronto.ca

© 2010 Lippincott Williams & Wilkins, Inc.