AUA 2019: AdVance XP® for the Treatment of Post-Prostatectomy-Incontinence: 5 Year Data of a Prospective Multicentre Study
There were 115 patients were included. Patients with previous urinary incontinence (UI) surgery, previous radiotherapy, nocturnal UI and a functional urethra < 1cm in the preoperative repositioning test were excluded. Postoperatively, a standardized 24-h pad test, quality-of-life scores [International Quality of Life score (IQOL) and International Consultation on Incontinence Questionnaire short form (ICIQ-UI SF)], visual analogue scale (VAS) for pain, five-item version of the International Index of Erectile Function (IIEF-5), International Prostate Symptom Score (IPSS) and Patient Global Impression of Improvement (PGI-I) score were carried out.
The result showed thatthe mean preoperative urine loss in the 24-h pad test was 341g (median 272.0 g). After a follow-up of 24 months (102 patients), 66,7% of the patients were cured and 26,5% had improved. The mean urine loss decreased significantly to 18,6 g (P < 0.001), with a mean VAS score of 0.3, and mean PGI-I of 1.5. After a follow-up of 48 months (60 patients), 71,7% of the patients were cured and 15.0% had improved. The mean urine loss decreased significantly to 24.4g (P < 0.001), with a mean VAS score of 0.1, and mean PGI-I of 1.4. The mean IQOL and ICIQ-UI SF improved significantly (both P < 0.001). After a follow-up of 60 months (36 patients), 61,1% of the patients were cured and 19,4% had improved. The mean urine loss decreased significantly to 24,2 g (P < 0.001), with a mean VAS score of 0.2, and mean PGI-I of 1.6. The mean IQOL and ICIQ-UI SF improved significantly (both P < 0.001) after 60 months. There were no significant postoperative changes in IIEF-5 and IPSS. No intraoperative and no long-term complications occurred. No erosion or explantation occurred. Due to a presumable intraoperative overcorrection of the sling during Repositioning or/and Tyvek-cover removal, six patients (5,2%; n=115) showed persistent postoperative residual urine in these patients dissection of one sling arm was necessary. In result, the operation technique in further procedures was adjusted. Later on, no additional cases with residual urine occurred.
The conclusion was made that 5 years follow up results showed a good continence rate and demonstrate a stable effectiveness over the years, low complication rates and considerably improved quality life scores in the use of the AdVance XP.
Presented by: Jan-Niclas Mumm, Medical Assistant for Urology, University of Munich, LMU, Munich, Germany
Co-authors: Benedikt Klehr, Munich, Germany, Christian Gozzi, Bozen, Italy, Peter Rehder, Florian May, Dachau, Germany, Roland Homberg, Hamm, Germany, Peter Gebhartl, Vocklabruck, Austria, Christian Stief, Ricarda Bauer, Munich, Germany
Written by: Bilal Farhan, MD, Clinical Instructor, Female Urology and Voiding Dysfunction, Department of Urology, University of California, Irvine @BilalfarhanMD at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois