Usefulness of Mesh Reinforcement in Pubic Fixation Urethral Sling Surgery for Urinary Incontinence After Radical Prostatectomy

Objectives

In our institution, a unique sling technique is performed for urinary incontinence after radical prostatectomy. However, in cases of severe urinary incontinence or in the medium to long term, the therapeutic effect may be insufficient. Therefore, a urethral sling technique that provides stronger compression of the bulbar urethra was developed, and its effectiveness was compared with the conventional technique.

Methods

Seventeen cases of conventional sling surgery and 16 cases of improved sling surgery were included. The number of pads used per day, safety pad rate, and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were evaluated before and after surgery, and a retrospective comparison was made between the two groups. Furthermore, patients were divided into those who used ≤ 4 pads per day before surgery and those who used ≥ 5 pads per day, and the difference between the two groups was examined. We also examined changes over time between groups.

Results

Compared with the conventional group, the improved group showed significant improvement in the number of pads per day, safety pad rate, and ICIQ-SF 18 months after surgery. In the group with ≤ 4 preoperative pads, the improved group showed significant improvement in all safety pad rates except at 1 and 12 months after surgery. There were no significant differences in all items between the two groups when the number of preoperative pads was ≥ 5.

Conclusions

The improved urethral sling technique appeared to contribute to improving moderate urinary incontinence by adding a simple procedure, especially for patients using ≤ 4 pads per day.