Long-term Functional Outcomes and Patient Satisfaction After AdVance and AdVanceXP Male Sling Surgery

Area of Science:

• Urology
• Medical Devices
• Patient Outcomes

Background:

• Transobturator male slings, including AdVance and AdVanceXP, are increasingly used for male urinary incontinence.
• Previous studies indicate their safety and efficacy.

Purpose of the Study:

• To assess long-term functional outcomes and patient satisfaction following AdVance or AdVanceXP sling implantation for non-neurogenic male stress urinary incontinence.
• To identify factors predicting poorer outcomes or lower satisfaction.

Main Methods:

• Retrospective analysis of 216 patients who underwent AdVance or AdVanceXP sling surgery (June 2007-April 2018).
• Long-term outcomes and satisfaction were evaluated in 172 patients via standardized questionnaires in April 2020.
• Median follow-up was 49 months.

Main Results:

• At 5 years, overall social continence was 66% (79% in an ideal population).
• Continence rates decreased to 42% at 10 years.
• Patient satisfaction was 71% at 5 years (77% in the ideal population).
• Prior pelvic radiotherapy, incontinence surgery, or urethral stricture surgery were linked to lower continence and satisfaction.

Conclusions:

• AdVance and AdVanceXP slings offer acceptable long-term continence and satisfaction, though these diminish over time.
• Patients with specific prior treatments require careful counseling regarding potential risks for sling failure.