Elsevier

Urology

Volume 110, December 2017, Pages 177-183
Urology

Prostatic Diseases and Male Voiding Dysfunction
Argus-T Sling in 182 Male Patients: Short-term Results of a Multicenter Study

https://doi.org/10.1016/j.urology.2017.07.058Get rights and content

Objective

To evaluate the short-term results with Argus-T sling in patients with post-prostatectomy incontinence (PPI).

Materials and Methods

A total of 182 patients with PPI were treated with Argus-T sling at 5 urologic centers from June 2008 to March 2013. The preoperative evaluation included medical history, pad count (1-2 pads: mild PPI; 3-5 pads: moderate PPI; >5 pads: severe PPI), visual analog scale on continence, quality of life score scale, physical examination, cystoscopy, and urodynamic evaluation.

Postoperative evaluation was performed 6 weeks postoperatively, and late follow-up was achieved in April 2013. We considered a successful result when patients were cured (0-1 pads/24 hours) and or improved (1-2 pads/24 hours or a reduction in pad per day usage greater than 50%).

Results

Twenty-one (11.8%), 96 (52.7%), and 65 (35.7%) patients have mild, moderate, and severe incontinence, respectively. At the median follow-up of 22 months, the overall success rate was 86.2%. We obtained successful results of 95% in mild incontinence, 78% in moderate incontinence and 70% in severe incontinence. In cured and improved patients, we observed a statistically significant amelioration of quality of life (P <.0001).

Sling regulation was carried out in 42.9% of cases, whereas its removal occurred in 9.3% of cases. Postoperative complications were reported in 14.3% of patients. In patients with previous radiotherapy, we observed a successful result in 61.2% of cases.

Conclusion

This study represents the first report that shows short-term results of Argus-T positioning in a large population. Argus-T seems to offer good outcomes in patients with mild and moderate PPI.

Section snippets

Patients

The records of 182 patients treated with the Argus-T sling at 4 institutions since June 2008 to March 2013 were evaluated.

Eligible patients had PPI after radical prostatectomy, TURP, or after failure of a previous AUS, Adjustable Continence Therapy, urethral constrictor, or other male slings. We considered eligible all patients having persistent PPI at least 6-12 months after the surgery. The patients quantified their PPI according to 24 hours pad test as follows: 1-2 pads per 24 hours as mild

Patient Characteristics

A total of 182 patients with SUI were treated with Argus-T sling with trans-obturator approach at 5 urologic centers from June 2008 to March 2013. The median age is 71 years (range 50-86 years), and the median follow-up is 22 months (range 1-59 months) (Table 1).

Twenty-one of 182 patients (11.6%) had mild incontinence (1-2 pads per 24 hours), 96 of 182 patients (52.7%) had moderate incontinence (3-5 pads per 24 hours), and 65 of 182 patients (35.7%) had severe incontinence (more than 5 pads per

Comment

In mini-invasive approaches, such as robotic and laparoscopic surgery, PPI represents an important postoperative complication, causing a decrease in QoL of these patients.1, 12

Percentage of PPI at 24 months after surgical operation ranges between 1% and 40% of patients who underwent radical prostatectomy.2, 3

It is known that PPI is caused by a reduced urethral resistance to abdominal pressure, secondary to the intrinsic sphincter deficiency.13, 14, 15

According to the international guidelines,

Conclusion

This study represents the first report that shows short-term results of Argus-T positioning in a large cohort of patients with SUI. Argus-T seems to offer good outcomes in patients with mild and moderate PPI.

In case of previous radiotherapy, Argus-T is associated with a low possibility to recover a satisfactory continence.

References (27)

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Financial Disclosure: The authors declare that they have no relevant financial interests.

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