Clinical results of a dorsally positioned hydraulic ID-sling in male patients with post-prostatectomy-incontinence

Sabina Sevcenco, P. Nyírády, Attila Majoros, Lukas Lusuardi, Hans Christoph Klingler

Research output: Contribution to journalArticle

Abstract

Purpose: To prospectively evaluate the effectiveness and safety of and the long-term experience with a re-adjustable hydraulic sling (ID-sling) device positioned dorsally to the urethra for the treatment of male post-prostatectomy incontinence (PPI). Materials and methods: Between September 2007 and November 2009 13 patients with persisting SUI were treated consecutively with an ID-sling™ in two European tertiary centers by a single surgeon. Physical examinations and standardized questionnaires (ICIQ-SF + VAS), pad tests, and 24-h pad number counts were performed at baseline and during follow-up. Results: The implantation of the hydraulic cuff was uncomplicated in all cases. The ICIQ-SF score diminished from a preoperative mean value of 18 to a mean of five postoperatively. One patient remained completely dry with normal micturition. All patients demonstrated a mild improvement at primary filling but did not show any significant improvement after the second or any subsequent filling. In total, 1/13 (7.7%) patients were completely dry and 5/13 (38.4%) showed improved continence. In 6/13 (46.2%) patients, satisfactory continence results according to subjective criteria, were not achieved. Subsequently, artificial urinary sphincter (AUS) implantation was offered to one patient (7.7%) after 12 months and to ten patients (76,9%) after 24 months. Conclusions: The implantation of a dorsally placed hydraulic sling is a not yet standardized and complex procedure, even for the experienced surgeon. To date, this implantation method is not an alternative to other devices. An improved sling design is necessary to simplify the surgical procedure and to improve long-term stability.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalWorld Journal of Urology
DOIs
Publication statusAccepted/In press - Jul 5 2018

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Suburethral Slings
Prostatectomy
Artificial Urinary Sphincter
Equipment and Supplies
Urination
Urethra
Physical Examination
Safety

Keywords

  • Adjustable male hydraulic urethral sling
  • Male stress urinary incontinence
  • Radical prostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Clinical results of a dorsally positioned hydraulic ID-sling in male patients with post-prostatectomy-incontinence. / Sevcenco, Sabina; Nyírády, P.; Majoros, Attila; Lusuardi, Lukas; Klingler, Hans Christoph.

In: World Journal of Urology, 05.07.2018, p. 1-7.

Research output: Contribution to journalArticle

Sevcenco, Sabina ; Nyírády, P. ; Majoros, Attila ; Lusuardi, Lukas ; Klingler, Hans Christoph. / Clinical results of a dorsally positioned hydraulic ID-sling in male patients with post-prostatectomy-incontinence. In: World Journal of Urology. 2018 ; pp. 1-7.
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abstract = "Purpose: To prospectively evaluate the effectiveness and safety of and the long-term experience with a re-adjustable hydraulic sling (ID-sling) device positioned dorsally to the urethra for the treatment of male post-prostatectomy incontinence (PPI). Materials and methods: Between September 2007 and November 2009 13 patients with persisting SUI were treated consecutively with an ID-sling™ in two European tertiary centers by a single surgeon. Physical examinations and standardized questionnaires (ICIQ-SF + VAS), pad tests, and 24-h pad number counts were performed at baseline and during follow-up. Results: The implantation of the hydraulic cuff was uncomplicated in all cases. The ICIQ-SF score diminished from a preoperative mean value of 18 to a mean of five postoperatively. One patient remained completely dry with normal micturition. All patients demonstrated a mild improvement at primary filling but did not show any significant improvement after the second or any subsequent filling. In total, 1/13 (7.7{\%}) patients were completely dry and 5/13 (38.4{\%}) showed improved continence. In 6/13 (46.2{\%}) patients, satisfactory continence results according to subjective criteria, were not achieved. Subsequently, artificial urinary sphincter (AUS) implantation was offered to one patient (7.7{\%}) after 12 months and to ten patients (76,9{\%}) after 24 months. Conclusions: The implantation of a dorsally placed hydraulic sling is a not yet standardized and complex procedure, even for the experienced surgeon. To date, this implantation method is not an alternative to other devices. An improved sling design is necessary to simplify the surgical procedure and to improve long-term stability.",
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