[en] [en] BACKGROUND: In 2017, a prospective multicenter, multinational, investigational pilot study was conducted examining outcomes using a novel surgical technique, the Mini-Jupette sling, for the management of erectile dysfunction (ED) patients with climacturia and/or minimal stress urinary incontinence (SUI) after prostate procedures. Climacturia has been reported in up to 64% of patients following radical prostatectomy (RP). We sought to report the 5-year outcomes from this original cohort to assess long-term safety and effectivity of the mini-jupette sling in the treatment of ED and concomitant mild SUI and/or climacturia.
METHODS: This is a single-arm, multicenter, retrospective, observational study. We identified patients who were enrolled in the previous multicenter study with post-RP ED and climacturia and/or mild SUI- 2 PADS PER DAY (PPD) and underwent inflatable penile prosthesis (IPP) insertion with simultaneous placement of a mini-jupette sling. Data were collected including current PPD, subjective improvement in climacturia/SUI, complications, need for revision of IPP or additional urinary incontinence surgery, and date of most recent follow-up. SPSS was used for statistical analysis.
RESULTS: Of the original 38 patients, 5 have since died and 10 were lost to follow-up with 23/38 (61%) patients available for evaluation of long-term outcomes. The average follow-up time was 59 months (SD =8.8) with a mean age of 69 years (SD =6.8). Most patients (n=21, 91%) had subjective improvement of SUI and climacturia. One patient with persistent bothersome incontinence underwent artificial urinary sphincter (AUS) placement in 2018 with no complications, while the other is still considering a repeat procedure due to minor but persistent SUI. The mean PPD decreased from 1.4 preoperatively to 0.4 at a mean of 5 years of follow-up. Most patients reported satisfaction in their urinary symptoms with 91% and 73% reporting improvement in SUI and climacturia respectively, compared to 86% and 93% respectively in the original series. One (4.3%) patient had an IPP revision for pump malfunction. There were no device infections reported.
CONCLUSIONS: The mini-jupette sling appears to be a safe and effective procedure with durable improvements in SUI and climacturia at 5 years of follow-up.
Disciplines :
Urology & nephrology
Author, co-author :
Hammad, Muhammed A M ; University of California-Irvine, Irvine, CA, USA
Barham, David W; University of California-Irvine, Irvine, CA, USA
Osmonov, Daniar; University Hospital Schleswig-Holstein, Kiel, Germany
Hatzichristodoulou, Georgios; Julius-Maximilians-University of Würzburg, Würzburg, Germany
van Renterghem, Koenraad; Jessa Hospital, Hasselt, Belgium
Andrianne, Robert ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'urologie
Park, Sung Hun; Sewum Prosthetic Urology Center of Excellence, Seoul, Korea
Kohler, Tobias S; Mayo Clinic, Rochester, MN, USA
Hellstrom, Wayne J G; Tulane University, New Orleans, LA, USA
Jenkins, Lawrence; University of California-Irvine, Irvine, CA, USA
Yafi, Faysal A; University of California-Irvine, Irvine, CA, USA
Language :
English
Title :
Long-term assessment of the safety and effectivity of the mini-jupette sling: 5-year follow-up of the original series.
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