Post-Prostatectomy Incontinence, Initial Experience and Results with One Year’s Experience

Purpose: Post-prostatectomy incontinence remains a problem, even in minor or moderate degrees. In order to minimize surgical morbidity and costs, sling procedures have been proposed. The authors have developed a new transobturator male sling procedure and report their results after one-year experience. Materials and Methods: A prospective multicenter study was conducted in 50 patients with minor or moderate post-pros-tatectomy incontinence. Evaluation of TOMSTM two arms bulbar sling was based on clinical form assessment, The Inter-national Consultation on Incontinence Questionnaire (ICIQ) and short-form (SF) 36 questionnaire pre and postoperatively and at 3, 6, 9 and 12 months. Results: The surgical procedure was considered easy to perform and no post-surgery complication was reported except for one retention. The median number of pads per day decreased significantly from 2 pads before surgery (95 % CI: 2- 3) to 1 during the follow-up period (95 % CI: 0- 2 at 360 days), and at 3 months patients using none or one pad per day were 30 % and 32 % respectively. The SF 36 continence and quality of life score improved from a median of 100 (95 % CI: 83- 133) to 300 (95 % CI: 167- 375), and the median ICIQ incontinence and quality of life score decreased from 15 (95% CI: 14- 16) to 8 (95 % CI: 5- 12) one year after surgery. Conclusion: The transobturator perineal male sling TOMSTM is an attractive simple sling technique for moderate or minor post-prostatectomy stress incontinence and offers an improvement in the quality of life