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Male Readjustable Sling (MRS) System for Postprostatectomy Incontinence: Experiences of 2 Centers.

 Sang Woon Kim  ;  Rhonda Walsh  ;  Yitzhak Berger  ;  Jang Hwan Kim 
 UROLOGY, Vol.88 : 195-200, 2016 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prostatectomy/adverse effects ; Prosthesis Design ; Retrospective Studies ; Risk Factors ; Suburethral Slings* ; Treatment Outcome ; Urinary Incontinence/etiology ; Urinary Incontinence/surgery*
OBJECTIVE: To evaluate the outcomes of Male Readjustable Sling (MRS) in patients with postprostatectomy incontinence at 2 unrelated centers and to determine preoperative factors relevant to the outcome.
MATERIALS AND METHODS: From January 2007 to January 2014, a total of 64 men with urinary incontinence following radical prostatectomy were treated with MRS at 2 centers. Patients were evaluated based on medical history, daily pad usage, urodynamics, and cystoscopy. The clinical outcome was evaluated according to daily pad usage and questionnaires. Success was defined according to reductions in the number of pads used per day after surgery, and factors related to surgical outcome were investigated.
RESULTS: The median age of the patients was 70 years (range: 53-84), and the mean follow-up duration was 46.0 ± 19.47 months (range: 12-89). During follow-up, readjustment of the sling was required 1.9 times on average. Daily pad usage decreased significantly from 3.42 ± 2.00 to 0.84 ± 1.20 (P <.001), and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form score improved (18.65 ± 2.61 to 10.55 ± 6.21, P <.001) without deterioration of voiding symptoms at the last follow-up. MRS was successful in 46 of 64 patients (71.9%). Of the 18 patients who experienced surgical failure, 12 patients required secondary artificial urethral sphincter implantation. The number of daily used pads (odds ratio 1.414) and a history of pelvic irradiation (odds ratio 8.400) were potential risk factors for surgical failure.
CONCLUSION: According to our midterm follow-up data, MRS is an effective and a safe treatment option for radiation-naïve patients with a mild degree of postprostatectomy incontinence.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Woon(김상운) ORCID logo https://orcid.org/0000-0002-5790-1948
Kim, Jang Hwan(김장환) ORCID logo https://orcid.org/0000-0002-9056-7072
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