Purpose: The success rate of the bulbourethral sling procedure to treat pos
t-radical prostatectomy incontinence has been reported in a previous chart
review analysis. WE! present further evaluation of the procedure using post
operative mailed questionnaires.
Materials and Methods: Between October 1994 and October 1997, 66 men underw
ent the bulbourethral sling procedure at our hospital. Postoperatively all
patients with indwelling bolsters were mailed questionnaires to assess cont
inence status, discomfort and voiding patterns.
Results: Of the 66 patients 4 required bolster removal for infection (2), e
rosion (1) or pain (1), and 1 died. These patients were not assessed furthe
r. Questionnaire data were obtained from the remaining 61 patients. At a me
dian followup of 9.6: months (mean 11.9, range 3 to 30) 25 patients (41%) r
eported complete cure of incontinence, 32 (53%) required no pad for protect
ion and 52 (85%) required 2 pads or less. Persistent perineal numbness or d
iscomfort was present in 32 patients (52%), Of 12 patients who received adj
uvant radiation therapy only 1 (8%) was cured.
Conclusions: The short-term success rate following the bulbourethral sling
procedure is high but persistent perineal discomfort is common. Adjuvant ra
diation predisposes to treatment failure.