The Department of Urology at the Hospital São João in Portugal
examined the intermediate-term outcome (up to 4 years) of a bone-anchored perineal sling (InVance(TM), produced by American Medical Systems, Minnetonka, MN, USA) in men with stress urinary incontinence (SUI) after prostate surgery.

Sixty two men with SUI after prostate cancer surgery were given the InVance sling. Implantation of the InVance bone-anchored bulbourethral sling was conducted primarily under spinal anaesthesia.

The men were considered cured, if they stopped wearing continence pads and improved if the daily number of pads used decreased by at least half. They were also administered the Incontinence Quality of Life questionnaire and a simple verbal question about patient satisfaction with the surgery were also used and complications were measured.

Forty patients (65%) were cured and fourteen (23%) were improved after a mean follow-up of 28 months. The UI cure rates at 3 and 4 years follow-up were 70% and 66%, respectively.

The most commonly reported side-effect was transient scrotal or perineal pain or numbness, which affected twelve patients (19%). Additionally, there was a prolonged postvoid residual urine volume of >100 mL in six patients (10%), which resolved within 2 weeks of indwelling catheterization.

Two men (3%) required removal of the sling because of infection. In one patient (2%), revision was required for bone-anchor dislodgement.

The hospital concluded that the InVance sling offers good intermediate-term cure and improvement rates for SUI after prostatectomy. The procedure has an acceptably low rate of minor complications, and should be considered for treating men with less severe forms of SUI

BJU Int. 2008 Sep 8. Epub ahead of print.

PubMed Abstract

Joel T Nowak MA, MSW