Reconstructive SurgeryUrodynamic Parameters After Retrourethral Transobturator Male Sling and Their Influence on Outcome
Section snippets
Material and Methods
Between February 2006 and December 2009, 55 consecutive patients were treated with RTS in a prospective, sequential clinical study. All patients were recruited from our outpatient office and consecutively included if they had SUI after radical prostatectomy. All of them had a history of failed pelvic floor training.
Informed consent forms were received from all patients after ethical approval by the local institutional review board. The data were collected before RTS and at standardized
Results
Characteristics and specific preoperative data of patients recruited for RTS placement are listed in Table 1. The mean follow-up was 21 ±11.7 months (range, 12-41). At maximum follow-up, the cure rate was 47% (26/55 patients) and the improvement rate was 26% (14/55 patients). The failure rate was 27% (15/55 patients).
No intraoperative complications were observed. Postoperative AUR (23.6%, 13/55 patients) was treated with suprapubic or transurethral catheter for a time span ranged between 4 days
Comment
SUI remains one of the major complications after radical prostatectomy with significant negative impact on QoL. The RTS is described as a functional and nonobstructive device for treatment of SUI,6 showing a high efficacy rate in the mid-term follow-up.7, 8
The present study was conducted to evaluate changes of urodynamic parameters before and after RTS placement and the impact of adverse preoperative urodynamic parameters on postoperative outcome. At maximum follow-up, the cure rate was 47% and
Conclusions
RTS suspension is an effective and safe device for SUI treatment, without signs of urethral obstruction or any influence on voiding parameters, except for ALPP. Low ALPP, low bladder capacity, and low flow do not adversely affect the RTS outcome. Preoperative urodynamic evaluation has no predictive value on RTS outcome and should be reserved only for selected patients with symptoms of overactive bladder or to exclude neurogenic bladder dysfunction.
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Current address: Department of Urology (Chair: Dr. C. Gozzi), Hospital Brixen, Brixen, Italy