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The role of synthetic slings in male stress incontinence.

Crites MA, Sorial A, Ghoniem GM - Arab J Urol (2011)

Bottom Line: Data were categorised into groups based on outcomes of 'dry', 'improved' and 'failure'.Urethral insult (P = 0.001) and preoperative pad use (P = 0.047) were significant predictors of failure.TOMS gave better outcomes than BAMS in both performance and patient satisfaction.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Section Voiding Dysfunction, Urodynamics and Female Urology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.

ABSTRACT

Objective: Our primary aim was to compare the outcomes of synthetic bone-anchored male slings (BAMS) and transobturator male slings (TOMS), to identify preoperative risk factors for failure, and to evaluate patient satisfaction with each procedure.

Patients and methods: Charts were reviewed retrospectively of patients who underwent synthetic BAMS or TOMS from 2000 to 2011. Data were categorised into groups based on outcomes of 'dry', 'improved' and 'failure'. Success was defined as completely dry or an improvement by >50% in daily pad use. The data analysed included demographics, daily pad use before and after surgery, previous urethral insult, type of prostatectomy, and urodynamic study variables. Data were analysed using logistical regression, the t-test and chi-square analysis, where appropriate.

Results: Sixty-eight men were analysed (30 in each group; eight patients were excluded). Daily pad use for the TOMS group changed from 3.5 before to 1.5 after surgery (P = 0.001), whilst the BAMS group was unchanged from 3.9 to 3.5 (P = 0.747). The TOMS group had a success rate of 23/30 (77%) and a mean (SD) patient global impression of improvement score of 1.67 (0.90), whilst the BAMS group had a success rate of 11/30 (37%) and mean (SD) score of 2.64 (1.12). Urethral insult (P = 0.001) and preoperative pad use (P = 0.047) were significant predictors of failure.

Conclusion: TOMS gave better outcomes than BAMS in both performance and patient satisfaction. Patients with a greater severity of incontinence and evidence of urethral insult before surgery should be counselled about the likelihood of suboptimal outcomes with any type of sling placement.

No MeSH data available.


Related in: MedlinePlus

Patient global impression of improvement.
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f0005: Patient global impression of improvement.

Mentions: The data analysed included pre-operative and post-operative daily pad usage, history of previous urethral disease or insult (i.e. urethral stricture disease, brachytherapy, external beam radiation therapy, etc.), urodynamic study (UDS) parameters, adverse events, and pre-operative presence of detrusor overactivity (DO) as found on UDS prior to sling placement. Each patient was asked to complete the validated patient global impression of improvement (PGII), a seven-point Likert scale, at each post-operative visit (Fig. 1) [6].


The role of synthetic slings in male stress incontinence.

Crites MA, Sorial A, Ghoniem GM - Arab J Urol (2011)

Patient global impression of improvement.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150600&req=5

f0005: Patient global impression of improvement.
Mentions: The data analysed included pre-operative and post-operative daily pad usage, history of previous urethral disease or insult (i.e. urethral stricture disease, brachytherapy, external beam radiation therapy, etc.), urodynamic study (UDS) parameters, adverse events, and pre-operative presence of detrusor overactivity (DO) as found on UDS prior to sling placement. Each patient was asked to complete the validated patient global impression of improvement (PGII), a seven-point Likert scale, at each post-operative visit (Fig. 1) [6].

Bottom Line: Data were categorised into groups based on outcomes of 'dry', 'improved' and 'failure'.Urethral insult (P = 0.001) and preoperative pad use (P = 0.047) were significant predictors of failure.TOMS gave better outcomes than BAMS in both performance and patient satisfaction.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Section Voiding Dysfunction, Urodynamics and Female Urology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.

ABSTRACT

Objective: Our primary aim was to compare the outcomes of synthetic bone-anchored male slings (BAMS) and transobturator male slings (TOMS), to identify preoperative risk factors for failure, and to evaluate patient satisfaction with each procedure.

Patients and methods: Charts were reviewed retrospectively of patients who underwent synthetic BAMS or TOMS from 2000 to 2011. Data were categorised into groups based on outcomes of 'dry', 'improved' and 'failure'. Success was defined as completely dry or an improvement by >50% in daily pad use. The data analysed included demographics, daily pad use before and after surgery, previous urethral insult, type of prostatectomy, and urodynamic study variables. Data were analysed using logistical regression, the t-test and chi-square analysis, where appropriate.

Results: Sixty-eight men were analysed (30 in each group; eight patients were excluded). Daily pad use for the TOMS group changed from 3.5 before to 1.5 after surgery (P = 0.001), whilst the BAMS group was unchanged from 3.9 to 3.5 (P = 0.747). The TOMS group had a success rate of 23/30 (77%) and a mean (SD) patient global impression of improvement score of 1.67 (0.90), whilst the BAMS group had a success rate of 11/30 (37%) and mean (SD) score of 2.64 (1.12). Urethral insult (P = 0.001) and preoperative pad use (P = 0.047) were significant predictors of failure.

Conclusion: TOMS gave better outcomes than BAMS in both performance and patient satisfaction. Patients with a greater severity of incontinence and evidence of urethral insult before surgery should be counselled about the likelihood of suboptimal outcomes with any type of sling placement.

No MeSH data available.


Related in: MedlinePlus