485 THE ADVANCE MALE SLING FOR INTRINSIC SPHINCTER DEFICIENCY IN PAEDIATRIC UROLOGY: 5 YEAR EXPERIENCE IN TWO REFERRAL CENTRES

Field: Medicine (Health Sciences)

You have accessJournal of UrologyPediatrics: Neuropathic Bladder/Reconstruction1 Apr 2013485 THE ADVANCE MALE SLING FOR INTRINSIC SPHINCTER DEFICIENCY IN PAEDIATRIC UROLOGY: 5 YEAR EXPERIENCE IN TWO REFERRAL CENTRES Luitzen-Albert Groen, Anne-Françoise Spinoit, Erik Van Laecke, Karel Everaert, Piet Hoebeke, and Ramnath Subramaniam Luitzen-Albert GroenLuitzen-Albert Groen Ghent, Belgium More articles by this author , Anne-Françoise SpinoitAnne-Françoise Spinoit Ghent, Belgium More articles by this author , Erik Van LaeckeErik Van Laecke Ghent, Belgium More articles by this author , Karel EveraertKarel Everaert Ghent, Belgium More articles by this author , Piet HoebekePiet Hoebeke Ghent, Belgium More articles by this author , and Ramnath SubramaniamRamnath Subramaniam Leeds, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1877AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of this study was to evaluate the combined experience of two centres with the AdVance male sling in treating urinary incontinence in boys. METHODS Over a five year period between 2007-2012, 21 boys underwent insertion of the AdVance male sling for urinary incontinence in two major centres (C1-13; C2-8). The aetiology of incontinence was neurogenic in 17 (C1-11; C2-6) and non neurogenic in 4 (C1-2; C2-2). Non neurogenic cases included epispadias (2), tumour (1) and duplicated urethra (1). Evaluation of the success of the procedure in imparting continence was assessed as per the Visual Analogue scale for incontinence (VAS) and the number of pads used. Cure was defined as 90% or greater decrease of incontinence. Improvement (partial response) as 50-90% decrease of symptoms and failure (no response) as less than 50% improvement. Careful assessment of the bladder and upper tracts was performed following this procedure for increased outlet resistance. RESULTS The sling was effective in 15 (C1-8; C2-7) of the 21 (71.4%) boys. The sling procedure failed in 6 (C1-5, C2-1) of the boys in this group (28.6%). The median age at insertion of the sling was 13.42 years (8-20). The mean follow up was 35.71 months (3-56). Of the 15 boys who responded well, 8 (C1-5; C2-3) of them were considered cured (53.3%; 38% of the entire group) and 7 (C1-3; C2-4) had partial response (47.7% and 33.3% for entire group). Among the 6 boys who failed, 1 (C2) had bladder neck injection with no further response and one (C1) has had bladder neck closure. Center C1 had some boys with local haematoma which resolved without any surgical intervention. Temporary problems with CIC was also noted in C1 which was resolved with changing the type of catheter. Center 2 has not seen any complication from the procedure itself. CONCLUSIONS Insertion of the AdVance male sling is a safe and effective minimally invasive option for achieving dryness in boys with urinary incontinence due to sphincter insufficiency. Results were comparable and reproducible in two referral centres. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e199 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luitzen-Albert Groen Ghent, Belgium More articles by this author Anne-Françoise Spinoit Ghent, Belgium More articles by this author Erik Van Laecke Ghent, Belgium More articles by this author Karel Everaert Ghent, Belgium More articles by this author Piet Hoebeke Ghent, Belgium More articles by this author Ramnath Subramaniam Leeds, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...