Post-Prostatectomy Male Sling Revision and Early Results

Urol Pract. 2016 Jan;3(1):36-40. doi: 10.1016/j.urpr.2015.03.008. Epub 2015 Oct 13.

Abstract

Introduction: Male slings are an accepted form of therapy in the incontinent man with a reported 55% to 80% success rate. Failed slings may be salvaged by performing a retensioning surgical sling revision procedure. The procedure is performed through a perineal incision that partially exposes the cicatrix containing the sling. Imbricating sutures are then placed and the patient is discharged home the same day without a catheter. Operative and postoperative details of this procedure are presented.

Methods: We retrospectively analyzed the records of the first 16 patients to undergo sling revision from June 2010 to March 2013. Patient age, pad count before and after initial sling placement, sling revision and followup time were investigated. Operative time, complications and blood loss were also analyzed.

Results: Median operative time was 37 minutes with a median blood loss of 5 ml. There were no surgical complications. The median daily pad count decreased from 4 to 1.3 (p = 0.002). After the procedure 63% of men improved and 44% were pad-free.

Conclusions: Sling revision appears promising as an easily reproducible salvage technique for failed slings.

Keywords: artificial; male slings; stress; surgical revision; urethra; urinary incontinence; urinary sphincter.