Five-Year Results of a Prospective Multicenter Trial: AdVance XP for Postprostatectomy-Incontinence in Patients with Favorable Prognostic Factors

Urol Int. 2021;105(5-6):421-427. doi: 10.1159/000512881. Epub 2021 Jan 29.

Abstract

Objective: The aim of this study was to assess the security, value, and efficacy of the second-generation AdVance male sling XP (Boston ScientificĀ®), after implementation in 2010 with advantageous modifications in the sling structure and needle shape, in a prospective multicenter long-term follow-up study.

Methods: In total, 115 patients were included. Exclusion criteria were earlier incontinence (UI) surgery, nocturnal UI, former radiotherapy, or night-time incontinence. We also excluded patients with a functional urethra <1 cm in a preoperatively performed repositioning test. A consistent 24-h pad test, International Quality of Life (IQOL) score, visual analog pain scale (VAS), International Consultation-Incontinence Questionnaire (ICIQ-UI SF), International Index of Erectile Function (IIEF-5), International Prostate Symptom Score (IPSS), and Patient Global Impression of Improvement (PGI-I) scores were requested postoperatively.

Results: The 24-month follow-up (114 patients) revealed 64.0% cured and 28.8% improved patients. Mean urine loss was reduced significantly to 19.0 g (p < 0.001). A mean PGI score of 1.5 and a mean VAS score of 0.2 were obtained. The 60-month follow-up (59 patients) revealed 57.6% cured and 25.4% improved patients. Mean urine loss was reduced significantly to 18.3 g (p < 0.001). A mean PGI score of 1.6 and a mean VAS score of 0.2 were obtained.

Conclusions: The AdVance XP displays excellent continence results and secure effectiveness over a 5-year period. Moreover, these data are demonstrating low complication rates and improved quality of life in the long-term use of AdVance XP.

Keywords: AdVance XP; Fixed male sling; Male stress urinary incontinence; Patient selection; Postprostatectomy-incontinence.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / surgery*
  • Prognosis
  • Prospective Studies
  • Prostatectomy*
  • Suburethral Slings* / adverse effects
  • Time Factors
  • Treatment Outcome
  • Urinary Incontinence / surgery*