| Researchers at the Department of Urology, University of Michigan, Ann Arbor, Michigan evaluated the complications associated with the male bone-anchored sling (BAS) to determine the appropriate preoperative counseling for men considering surgery. The BAS is a surgical option for the treatment of stress urinary incontinence (SUI) due to intrinsic sphincter deficiency.|
The researchers reviewed 119 men who had undergone 140 BAS procedures from May 2000 to May 2009. All complications were recorded during the follow-up visits.
Mean patient age was 65.8 years (range 23-89). Main etiologies for SUI included previous treatment of prostate cancer (82.4%), neurologic dysfunction (12.6%), and previous transurethral resection of the prostate (3.6%).
1- Recurrent SUI, de novo urge incontinence, and wound infection were the most frequent complications encountered (25.2%, 17.6%, and 16%, respectively).
2- The 3 most common reasons for reoperation included bulking agent injection for recurrent SUI (5.9%), sling revision for bone screw dislodgement (5.9%), and sling revision for recurrent SUI (5.0%).
3- Overall complication and reoperation rate for the index cases was 58.8% and 26.9%, respectively.
In my opinion the incidence of complications after male BAS is higher than often thought. Adequate counseling prior to surgery regarding the potential complications is important.
Additionally, it should be more clearly explained to men making treatment for prostate cancer the high risk they do face of experiencing recurrent SUI.
Reference: Urology. 2010 Sep 1.