Urodynamic evaluation of patients cured of their post-radical prostatectomy stress urinary incontinence following transobturator male sling implantation [Évaluation urodynamique de patients guéris d'incontinence urinaire d'effort post-prostatectomie radicale après implantation d'une bandelette sous-urétrale transobturatrice]

Introduction: The mechanism(s) responsible(s) for continence recovery after male sling implantation for post-radical prostatectomy incontinence are imperfectly known. The goal of this study was to evaluate urodynamic parameters before and after male sling insertion, only in patients cured of their stress urinary incontinence. Patients and methods: In total, 10 continent patients after transobturator male sling, with no history of urethral stenosis or pelvic radiation, were randomly selected from a database for urodynamic studies. Urodynamic parameters included urethral pressure profiles (UPP), with measurements of maximal urethral closure pressure (MUCP) and functional urethral length (FUL), and were compared with preoperative urodynamic data. Paired sampled were compared with the use of the Wilcoxon signed-rank test (StatPlus®). Results: Urodynamic studies were performed after a median time of 9 months (min 4 – max 34) following sling implantation. Postoperatively, a rise of 11 cm H2O in median MUCP (P = 0.09) and an increase of 14 mm in median FUL (P = 0.13) were observed. None of the urodynamic changes was statistically significant. Conclusions: Following sling implantation, modifications in UPPs were observed, with increases in MUCP and FUL but these increments were not statistically significant. Limitations to our study include biases inherent to the interpretation and reproducibility of urethral profilometry, the sample size, and the variable delay between sling implantation and postoperative urodynamic studies. Level of evidence: 4.