Retropubic vs transobturator Argus adjustable male sling: Results from a multicenter study

Loertzer, Hagen; Huesch, Tanja; Kirschner-Hermanns, Ruth; Anding, Ralf; Rose, Armin; Brehmer, Bernhard; Naumann, Carsten Maik; Queissert, Fabian; Nyarangi-Dix, Joanne; Homberg, Roland; Grabbert, Markus; Hofmann, Torben; Pottek, Tobias; Huebner, Wilhelm; Haferkamp, Axel; Bauer, Ricarda Michaela und Kretschmer, Alexander (2020): Retropubic vs transobturator Argus adjustable male sling: Results from a multicenter study. In: Neurourology and Urodynamics, Bd. 39, Nr. 3: S. 987-993

Abstract

Aims: To comparatively analyse outcomes after ARGUS classic and ArgusT adjustable male sling implantation in a real-world setting. Methods Inclusion criteria encompassed: non-neurogenic, moderate-to-severe stress urinary incontinence (>= 2 pads), implantation of an ARGUS classic or ArgusT male sling between 2010 and 2012 in a high-volume center (>150 previous implantations). Functional outcomes were assessed using daily pad usage, 24-hour pad testing, and International Consultation on Incontinence (ICIQ-SF) questionnaires. Continence was defined as zero pads per 24 hours. Complications were graded using Clavien-Dindo scale. For multivariate analysis, binary logistic regression models were used (P < .05). Results A total of 106 patients (n = 74 [ARGUS classic], n = 32 [ArgusT]) from four centers were eligible. Median follow-up was 44.0 months (24-64). Patient cohorts were well-balanced. We observed a statistical trend in favor of ARGUS classic regarding postoperative urine loss based on standardized 24-hour pad test (71 +/- 162 g [ARGUS classic] vs 160 +/- 180 g [ArgusT]);P = .066]. Dry rates were 33.3% (ARGUS classic) and 11.8% (ArgusT, P = .114). In multivariable analysis, ArgusT male sling could not be confirmed as an independent predictor of decreased success (OR, 0.587;95% CI;0.166-2.076, P = .408). There were no Clavien IV and V complications. Inguinal pain was significantly higher after ArgusT implantation (P = .033). Explantation rates were higher for ArgusT compared to ARGUS classic (14.0 vs 23.3%;P = .371). Longer device survival for the ARGUS classic male sling was observed in Kaplan-Meier analysis (P = .198). Conclusions: In the largest comparative analysis of ARGUS classic and ArgusT male sling with the longest follow-up to date, we observed low continence rates with superior functional outcomes and decreased explantation rates after ARGUS classic implantation.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0733-2467
• Sprache: Englisch