Long-term Success Durability of Transobturator Male Sling
| Autor: | Kurt A. McCammon, Michael E. Chua, Jack M Zuckerman, James Bradley Mason, Jessica DeLong, Jeremy Tonkin, Ramón Virasoro |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Urologic Surgical Procedures Male Male sling Urology Urinary Incontinence Stress Treatment outcome 030232 urology & nephrology Urinary incontinence Transobturator sling Treatment failure 03 medical and health sciences 0302 clinical medicine medicine Humans Survival analysis Aged Retrospective Studies Suburethral Slings business.industry Retrospective cohort study Surgery Prosthesis Failure Treatment Outcome 030220 oncology & carcinogenesis Concomitant medicine.symptom business Follow-Up Studies |
| Zdroj: | Urology. 133 |
| ISSN: | 1527-9995 |
| Popis: | OBJECTIVE To determine the long-term outcome of transobturator sling for male stress urinary incontinence (SUI) clustered according to preoperative SUI severity, and to identify predictors of treatment success durability and failure occurrence in long-term follow-up. METHOD A nonconcurrent study was conducted on all transobturator male sling cases performed from August 2006 to June 2012 by a single surgeon. Preoperative SUI severity was clustered into mild (≤2 ppd), moderate (3-4 ppd) or severe (≥5 ppd). Success was defined as complete dryness with 0 pads used (cured), and a patient with ≥50% improvement, satisfied without further procedures needed. Otherwise it was considered a treatment failure. Clinical variables significantly associated with long-term treatment success were determined. Time-to-event (Kaplan-Meier) and Multiple-Cox regression analysis were performed to determine predictors of long-term treatment outcome. RESULTS A total of 215 patients (mild-59, moderate-94, and severe-62) with a mean follow-up of 56.4 ± 41.6 months were included. On long-term follow-up, 150 (69.8%) patients-maintained treatment success and 96 (44.7%) were dry. The long-term outcome success clustered according to SUI severity as mild, moderate, and severe was 84.7%, 72.3%, and 51.6%, respectively. Kaplan-Meier with Log-rank test and Multiple Cox-regression determined that both concomitant urge incontinence and preoperative SUI severity were independent predictors of long-term durability of treatment success and failure occurrence. Preoperative SUI severity was the only predictor of long-term cure sustainability. CONCLUSION The time to event analysis with an average of ∼5 years postoperative follow-up has determined that the preoperative severity and presence of concomitant urge incontinence were independent predictors for long-term outcome. |
| Databáze: | OpenAIRE |
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