THE MALE BULBOURETHRAL SLING PROCEDURE FOR POSTRADICAL PROSTATECTOMY INCONTINENCE

Purpose: We evaluate the efficacy of the male bulbourethral sling proc edure in the treatment of post-radical prostatectomy urinary incontine nce. Materials and Methods: We reviewed the records of 64 consecutive men with severe postprostatectomy incontinence who underwent the male bulbourethral sling procedure at Northwestern Memorial Hospital and St anford University Hospital. Preoperatively 50% of the patients were co mpletely incontinent (diapers, clamps or condom catheter), and the rem ainder required a mean of 4.7 pads per day. Data were collected by cha rt review, patient interviews at followup appointments and telephone i nterviews. Median followup was 18.1 months (mean 22.4, range 6.5 to 53 .8). Results: Following a single sling procedure 36 patients (56%) bec ame dry, and 5 (8%) were significantly improved. In 17 patients 23 ret ightening procedures were performed, which decreased the median follow up to 16 months and increased the success rate to 75% (67% cured, 8% i mproved). The revision, erosion and infection rates were 27, 6 and 3%, respectively. Conclusions: The male bulbourethral sling procedure is effective treatment for post-radical prostatectomy urinary incontinenc e. Patients who had received adjuvant radiation therapy demonstrated a lower continence rate than those who had not. Further followup is nee ded to assess long-term efficacy.