Fixed or adjustable sling in the treatment of male stress urinary incontinence: results from a large cohort study
Background: Fixed and adjustable male slings for the treatment of male urinary stress incontinence became increasingly popular during the last decade. Although fixed slings are recommended for the treatment of mild to moderate stress urinary incontinence, there is still a lack of evidence regarding...
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| creator | Huesch, Tanja Kretschmer, Alexander Obaje, Alice Kirschner-Hermanns, Ruth Anding, Ralf Pottek, Tobias Rose, Achim Olianas, Roberto Friedl, Alexander Homberg, Roland Pfitzenmaier, Jesco Abdunnur, Rudi Queissert, Fabian Naumann, Carsten M. Schweiger, Josef Wotzka, Carola Nyarangi-Dix, Joanne Hofmann, Torben Ulm, Kurt Huebner, Wilhelm Bauer, Ricarda M. Haferkamp, Axel |
| description | Background: Fixed and adjustable male slings for the treatment of male urinary stress incontinence became increasingly popular during the last decade. Although fixed slings are recommended for the treatment of mild to moderate stress urinary incontinence, there is still a lack of evidence regarding the precise indication for an adjustable male sling. Furthermore, there is still no evidence that one type of male sling is superior to another. However, both, adjustable and fixed slings, are commonly utilized in daily clinical practice. This current investigation aims to evaluate the differences between fixed and adjustable male slings regarding indications, complication rates and functional outcome in the treatment of male stress urinary incontinence in current clinical practice. Methods: A total of 294 patients with a fixed and 176 patients with an adjustable male sling were evaluated in a multicenter single arm cohort trial. Data collection was performed retrospectively according the medical record. Functional outcome was prospectively analyzed by standardized, validated questionnaires. Descriptive statistics was performed to present patient characteristics, complication rates and functional outcome. A chi2-test for categorical and independent t -test for continuous variables was performed to identify heterogeneity between the groups and to correlate preoperative characteristics with the outcome. A P value |
| doi_str_mv | 10.21037/tau-19-852 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7354336</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2424993083</sourcerecordid><originalsourceid>FETCH-LOGICAL-c381t-a076be7985d56717ac2a289a93bc0c0a77d9a25358902970f6265251f3992f133</originalsourceid><addsrcrecordid>eNqNkb1vFDEQxS0EIlFIRY9cIqEN_lh_USChEwlIkWigtma93jtHu3Ziewn57_Fx4YCOypbfb2be-CH0kpILRglXbyusHTWdFuwJOmWM8a6Xhj493jU_Qeel3BBCKOO6l_Q5OuFMKskNP0V3l-GHH3HKGMabtVQYZo_LHOIWh4jrzuOaPdTFx4rThBfYy-2pFLzmECE_NM6lWEP00fl3uEnrXAueclow4Bny1mOXdinXVriODy_Qswnm4s8fzzP07fLj182n7vrL1efNh-vOcU1rB0TJwSujxSikogocA6YNGD444ggoNRpgggttCDOKTJJJwQSduDFsopyfofeHvrfrsPjRtQ0yzPY2h6W5tgmC_VeJYWe36btVXPScy9bg9WODnO5WX6pdQnF-niH6tBbLetYbw4nez3pzQF1OpWQ_HcdQYn_lZFtOlhrbcmr0q7-dHdnfqTRAH4B7P6SpuLD_2iPWkhS9ZlwKsg91EyrUkOImrbH-cfI_pfwnV9GwZA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2424993083</pqid></control><display><type>article</type><title>Fixed or adjustable sling in the treatment of male stress urinary incontinence: results from a large cohort study</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>PubMed Central</source><creator>Huesch, Tanja ; Kretschmer, Alexander ; Obaje, Alice ; Kirschner-Hermanns, Ruth ; Anding, Ralf ; Pottek, Tobias ; Rose, Achim ; Olianas, Roberto ; Friedl, Alexander ; Homberg, Roland ; Pfitzenmaier, Jesco ; Abdunnur, Rudi ; Queissert, Fabian ; Naumann, Carsten M. ; Schweiger, Josef ; Wotzka, Carola ; Nyarangi-Dix, Joanne ; Hofmann, Torben ; Ulm, Kurt ; Huebner, Wilhelm ; Bauer, Ricarda M. ; Haferkamp, Axel</creator><creatorcontrib>Huesch, Tanja ; Kretschmer, Alexander ; Obaje, Alice ; Kirschner-Hermanns, Ruth ; Anding, Ralf ; Pottek, Tobias ; Rose, Achim ; Olianas, Roberto ; Friedl, Alexander ; Homberg, Roland ; Pfitzenmaier, Jesco ; Abdunnur, Rudi ; Queissert, Fabian ; Naumann, Carsten M. ; Schweiger, Josef ; Wotzka, Carola ; Nyarangi-Dix, Joanne ; Hofmann, Torben ; Ulm, Kurt ; Huebner, Wilhelm ; Bauer, Ricarda M. ; Haferkamp, Axel ; Debates Male Incontinence DOMINO ; Debates On Male Incontinence (DOMINO)-Project</creatorcontrib><description>Background: Fixed and adjustable male slings for the treatment of male urinary stress incontinence became increasingly popular during the last decade. Although fixed slings are recommended for the treatment of mild to moderate stress urinary incontinence, there is still a lack of evidence regarding the precise indication for an adjustable male sling. Furthermore, there is still no evidence that one type of male sling is superior to another. However, both, adjustable and fixed slings, are commonly utilized in daily clinical practice. This current investigation aims to evaluate the differences between fixed and adjustable male slings regarding indications, complication rates and functional outcome in the treatment of male stress urinary incontinence in current clinical practice. Methods: A total of 294 patients with a fixed and 176 patients with an adjustable male sling were evaluated in a multicenter single arm cohort trial. Data collection was performed retrospectively according the medical record. Functional outcome was prospectively analyzed by standardized, validated questionnaires. Descriptive statistics was performed to present patient characteristics, complication rates and functional outcome. A chi2-test for categorical and independent t -test for continuous variables was performed to identify heterogeneity between the groups and to correlate preoperative characteristics with the outcome. A P value <0.05 was considered statistically significant. Results: Patients with higher degree of urinary incontinence (P<0.001) and risk factors such as history of pelvic irradiation (P<0.001) or prior surgery for urethral stricture (P=0.032) were more likely to receive an adjustable MS. Complication rates were comparable except for infection (P=0.009, 0 vs. 2.3%) and pain (P=0.001, 1.7% vs. 11.3%) which occurred more frequently in adjustable slings. Functional outcome according validated questionnaires demonstrated no differences between fixed and adjustable male slings. Conclusions: Adjustable male slings are more frequently utilized in patients with higher degree of incontinence and risk factors compared to fixed slings. No differences could be identified between functional outcome which may imply an advantage for adjustability. However, pain and infection rates were significantly higher in adjustable MS and should be considered in the decision process for sling type.</description><identifier>ISSN: 2223-4683</identifier><identifier>ISSN: 2223-4691</identifier><identifier>EISSN: 2223-4691</identifier><identifier>DOI: 10.21037/tau-19-852</identifier><identifier>PMID: 32676393</identifier><language>eng</language><publisher>SHATIN: AME PUBLISHING COMPANY</publisher><subject>Andrology ; Endocrinology & Metabolism ; Life Sciences & Biomedicine ; Original ; Science & Technology ; Urology & Nephrology</subject><ispartof>Translational andrology and urology, 2020-06, Vol.9 (3), p.1099-1107</ispartof><rights>2020 Translational Andrology and Urology. All rights reserved.</rights><rights>2020 Translational Andrology and Urology. All rights reserved. 2020 Translational Andrology and Urology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>8</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000548236500001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c381t-a076be7985d56717ac2a289a93bc0c0a77d9a25358902970f6265251f3992f133</citedby><cites>FETCH-LOGICAL-c381t-a076be7985d56717ac2a289a93bc0c0a77d9a25358902970f6265251f3992f133</cites><orcidid>0000-0001-6332-916X ; 0000-0002-7872-5496</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354336/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354336/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,887,27931,27932,28255,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32676393$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huesch, Tanja</creatorcontrib><creatorcontrib>Kretschmer, Alexander</creatorcontrib><creatorcontrib>Obaje, Alice</creatorcontrib><creatorcontrib>Kirschner-Hermanns, Ruth</creatorcontrib><creatorcontrib>Anding, Ralf</creatorcontrib><creatorcontrib>Pottek, Tobias</creatorcontrib><creatorcontrib>Rose, Achim</creatorcontrib><creatorcontrib>Olianas, Roberto</creatorcontrib><creatorcontrib>Friedl, Alexander</creatorcontrib><creatorcontrib>Homberg, Roland</creatorcontrib><creatorcontrib>Pfitzenmaier, Jesco</creatorcontrib><creatorcontrib>Abdunnur, Rudi</creatorcontrib><creatorcontrib>Queissert, Fabian</creatorcontrib><creatorcontrib>Naumann, Carsten M.</creatorcontrib><creatorcontrib>Schweiger, Josef</creatorcontrib><creatorcontrib>Wotzka, Carola</creatorcontrib><creatorcontrib>Nyarangi-Dix, Joanne</creatorcontrib><creatorcontrib>Hofmann, Torben</creatorcontrib><creatorcontrib>Ulm, Kurt</creatorcontrib><creatorcontrib>Huebner, Wilhelm</creatorcontrib><creatorcontrib>Bauer, Ricarda M.</creatorcontrib><creatorcontrib>Haferkamp, Axel</creatorcontrib><creatorcontrib>Debates Male Incontinence DOMINO</creatorcontrib><creatorcontrib>Debates On Male Incontinence (DOMINO)-Project</creatorcontrib><title>Fixed or adjustable sling in the treatment of male stress urinary incontinence: results from a large cohort study</title><title>Translational andrology and urology</title><addtitle>TRANSL ANDROL UROL</addtitle><addtitle>Transl Androl Urol</addtitle><description>Background: Fixed and adjustable male slings for the treatment of male urinary stress incontinence became increasingly popular during the last decade. Although fixed slings are recommended for the treatment of mild to moderate stress urinary incontinence, there is still a lack of evidence regarding the precise indication for an adjustable male sling. Furthermore, there is still no evidence that one type of male sling is superior to another. However, both, adjustable and fixed slings, are commonly utilized in daily clinical practice. This current investigation aims to evaluate the differences between fixed and adjustable male slings regarding indications, complication rates and functional outcome in the treatment of male stress urinary incontinence in current clinical practice. Methods: A total of 294 patients with a fixed and 176 patients with an adjustable male sling were evaluated in a multicenter single arm cohort trial. Data collection was performed retrospectively according the medical record. Functional outcome was prospectively analyzed by standardized, validated questionnaires. Descriptive statistics was performed to present patient characteristics, complication rates and functional outcome. A chi2-test for categorical and independent t -test for continuous variables was performed to identify heterogeneity between the groups and to correlate preoperative characteristics with the outcome. A P value <0.05 was considered statistically significant. Results: Patients with higher degree of urinary incontinence (P<0.001) and risk factors such as history of pelvic irradiation (P<0.001) or prior surgery for urethral stricture (P=0.032) were more likely to receive an adjustable MS. Complication rates were comparable except for infection (P=0.009, 0 vs. 2.3%) and pain (P=0.001, 1.7% vs. 11.3%) which occurred more frequently in adjustable slings. Functional outcome according validated questionnaires demonstrated no differences between fixed and adjustable male slings. Conclusions: Adjustable male slings are more frequently utilized in patients with higher degree of incontinence and risk factors compared to fixed slings. No differences could be identified between functional outcome which may imply an advantage for adjustability. However, pain and infection rates were significantly higher in adjustable MS and should be considered in the decision process for sling type.</description><subject>Andrology</subject><subject>Endocrinology & Metabolism</subject><subject>Life Sciences & Biomedicine</subject><subject>Original</subject><subject>Science & Technology</subject><subject>Urology & Nephrology</subject><issn>2223-4683</issn><issn>2223-4691</issn><issn>2223-4691</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><recordid>eNqNkb1vFDEQxS0EIlFIRY9cIqEN_lh_USChEwlIkWigtma93jtHu3Ziewn57_Fx4YCOypbfb2be-CH0kpILRglXbyusHTWdFuwJOmWM8a6Xhj493jU_Qeel3BBCKOO6l_Q5OuFMKskNP0V3l-GHH3HKGMabtVQYZo_LHOIWh4jrzuOaPdTFx4rThBfYy-2pFLzmECE_NM6lWEP00fl3uEnrXAueclow4Bny1mOXdinXVriODy_Qswnm4s8fzzP07fLj182n7vrL1efNh-vOcU1rB0TJwSujxSikogocA6YNGD444ggoNRpgggttCDOKTJJJwQSduDFsopyfofeHvrfrsPjRtQ0yzPY2h6W5tgmC_VeJYWe36btVXPScy9bg9WODnO5WX6pdQnF-niH6tBbLetYbw4nez3pzQF1OpWQ_HcdQYn_lZFtOlhrbcmr0q7-dHdnfqTRAH4B7P6SpuLD_2iPWkhS9ZlwKsg91EyrUkOImrbH-cfI_pfwnV9GwZA</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Huesch, Tanja</creator><creator>Kretschmer, Alexander</creator><creator>Obaje, Alice</creator><creator>Kirschner-Hermanns, Ruth</creator><creator>Anding, Ralf</creator><creator>Pottek, Tobias</creator><creator>Rose, Achim</creator><creator>Olianas, Roberto</creator><creator>Friedl, Alexander</creator><creator>Homberg, Roland</creator><creator>Pfitzenmaier, Jesco</creator><creator>Abdunnur, Rudi</creator><creator>Queissert, Fabian</creator><creator>Naumann, Carsten M.</creator><creator>Schweiger, Josef</creator><creator>Wotzka, Carola</creator><creator>Nyarangi-Dix, Joanne</creator><creator>Hofmann, Torben</creator><creator>Ulm, Kurt</creator><creator>Huebner, Wilhelm</creator><creator>Bauer, Ricarda M.</creator><creator>Haferkamp, Axel</creator><general>AME PUBLISHING COMPANY</general><general>AME Publishing Company</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6332-916X</orcidid><orcidid>https://orcid.org/0000-0002-7872-5496</orcidid></search><sort><creationdate>20200601</creationdate><title>Fixed or adjustable sling in the treatment of male stress urinary incontinence: results from a large cohort study</title><author>Huesch, Tanja ; Kretschmer, Alexander ; Obaje, Alice ; Kirschner-Hermanns, Ruth ; Anding, Ralf ; Pottek, Tobias ; Rose, Achim ; Olianas, Roberto ; Friedl, Alexander ; Homberg, Roland ; Pfitzenmaier, Jesco ; Abdunnur, Rudi ; Queissert, Fabian ; Naumann, Carsten M. ; Schweiger, Josef ; Wotzka, Carola ; Nyarangi-Dix, Joanne ; Hofmann, Torben ; Ulm, Kurt ; Huebner, Wilhelm ; Bauer, Ricarda M. ; Haferkamp, Axel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c381t-a076be7985d56717ac2a289a93bc0c0a77d9a25358902970f6265251f3992f133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Andrology</topic><topic>Endocrinology & Metabolism</topic><topic>Life Sciences & Biomedicine</topic><topic>Original</topic><topic>Science & Technology</topic><topic>Urology & Nephrology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huesch, Tanja</creatorcontrib><creatorcontrib>Kretschmer, Alexander</creatorcontrib><creatorcontrib>Obaje, Alice</creatorcontrib><creatorcontrib>Kirschner-Hermanns, Ruth</creatorcontrib><creatorcontrib>Anding, Ralf</creatorcontrib><creatorcontrib>Pottek, Tobias</creatorcontrib><creatorcontrib>Rose, Achim</creatorcontrib><creatorcontrib>Olianas, Roberto</creatorcontrib><creatorcontrib>Friedl, Alexander</creatorcontrib><creatorcontrib>Homberg, Roland</creatorcontrib><creatorcontrib>Pfitzenmaier, Jesco</creatorcontrib><creatorcontrib>Abdunnur, Rudi</creatorcontrib><creatorcontrib>Queissert, Fabian</creatorcontrib><creatorcontrib>Naumann, Carsten M.</creatorcontrib><creatorcontrib>Schweiger, Josef</creatorcontrib><creatorcontrib>Wotzka, Carola</creatorcontrib><creatorcontrib>Nyarangi-Dix, Joanne</creatorcontrib><creatorcontrib>Hofmann, Torben</creatorcontrib><creatorcontrib>Ulm, Kurt</creatorcontrib><creatorcontrib>Huebner, Wilhelm</creatorcontrib><creatorcontrib>Bauer, Ricarda M.</creatorcontrib><creatorcontrib>Haferkamp, Axel</creatorcontrib><creatorcontrib>Debates Male Incontinence DOMINO</creatorcontrib><creatorcontrib>Debates On Male Incontinence (DOMINO)-Project</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Translational andrology and urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huesch, Tanja</au><au>Kretschmer, Alexander</au><au>Obaje, Alice</au><au>Kirschner-Hermanns, Ruth</au><au>Anding, Ralf</au><au>Pottek, Tobias</au><au>Rose, Achim</au><au>Olianas, Roberto</au><au>Friedl, Alexander</au><au>Homberg, Roland</au><au>Pfitzenmaier, Jesco</au><au>Abdunnur, Rudi</au><au>Queissert, Fabian</au><au>Naumann, Carsten M.</au><au>Schweiger, Josef</au><au>Wotzka, Carola</au><au>Nyarangi-Dix, Joanne</au><au>Hofmann, Torben</au><au>Ulm, Kurt</au><au>Huebner, Wilhelm</au><au>Bauer, Ricarda M.</au><au>Haferkamp, Axel</au><aucorp>Debates Male Incontinence DOMINO</aucorp><aucorp>Debates On Male Incontinence (DOMINO)-Project</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fixed or adjustable sling in the treatment of male stress urinary incontinence: results from a large cohort study</atitle><jtitle>Translational andrology and urology</jtitle><stitle>TRANSL ANDROL UROL</stitle><addtitle>Transl Androl Urol</addtitle><date>2020-06-01</date><risdate>2020</risdate><volume>9</volume><issue>3</issue><spage>1099</spage><epage>1107</epage><pages>1099-1107</pages><issn>2223-4683</issn><issn>2223-4691</issn><eissn>2223-4691</eissn><abstract>Background: Fixed and adjustable male slings for the treatment of male urinary stress incontinence became increasingly popular during the last decade. Although fixed slings are recommended for the treatment of mild to moderate stress urinary incontinence, there is still a lack of evidence regarding the precise indication for an adjustable male sling. Furthermore, there is still no evidence that one type of male sling is superior to another. However, both, adjustable and fixed slings, are commonly utilized in daily clinical practice. This current investigation aims to evaluate the differences between fixed and adjustable male slings regarding indications, complication rates and functional outcome in the treatment of male stress urinary incontinence in current clinical practice. Methods: A total of 294 patients with a fixed and 176 patients with an adjustable male sling were evaluated in a multicenter single arm cohort trial. Data collection was performed retrospectively according the medical record. Functional outcome was prospectively analyzed by standardized, validated questionnaires. Descriptive statistics was performed to present patient characteristics, complication rates and functional outcome. A chi2-test for categorical and independent t -test for continuous variables was performed to identify heterogeneity between the groups and to correlate preoperative characteristics with the outcome. A P value <0.05 was considered statistically significant. Results: Patients with higher degree of urinary incontinence (P<0.001) and risk factors such as history of pelvic irradiation (P<0.001) or prior surgery for urethral stricture (P=0.032) were more likely to receive an adjustable MS. Complication rates were comparable except for infection (P=0.009, 0 vs. 2.3%) and pain (P=0.001, 1.7% vs. 11.3%) which occurred more frequently in adjustable slings. Functional outcome according validated questionnaires demonstrated no differences between fixed and adjustable male slings. Conclusions: Adjustable male slings are more frequently utilized in patients with higher degree of incontinence and risk factors compared to fixed slings. No differences could be identified between functional outcome which may imply an advantage for adjustability. However, pain and infection rates were significantly higher in adjustable MS and should be considered in the decision process for sling type.</abstract><cop>SHATIN</cop><pub>AME PUBLISHING COMPANY</pub><pmid>32676393</pmid><doi>10.21037/tau-19-852</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6332-916X</orcidid><orcidid>https://orcid.org/0000-0002-7872-5496</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Andrology Endocrinology & Metabolism Life Sciences & Biomedicine Original Science & Technology Urology & Nephrology |
| title | Fixed or adjustable sling in the treatment of male stress urinary incontinence: results from a large cohort study |
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