Objective: The aim of this study was to assess the security, value, and efficacy of the second-generation AdVance male sling XP (Boston Scientific®), after implementation in 2010 with advantageous modifications in the sling structure and needle shape, in a prospective multicenter long-term follow-up study. Methods: In total, 115 patients were included. Exclusion criteria were earlier incontinence (UI) surgery, nocturnal UI, former radiotherapy, or night-time incontinence. We also excluded patients with a functional urethra <1 cm in a preoperatively performed repositioning test. A consistent 24-h pad test, International Quality of Life (IQOL) score, visual analog pain scale (VAS), International Consultation-Incontinence Questionnaire (ICIQ-UI SF), International Index of Erectile Function (IIEF-5), International Prostate Symptom Score (IPSS), and Patient Global Impression of Improvement (PGI-I) scores were requested postoperatively. Results: The 24-month follow-up (114 patients) revealed 64.0% cured and 28.8% improved patients. Mean urine loss was reduced significantly to 19.0 g (p < 0.001). A mean PGI score of 1.5 and a mean VAS score of 0.2 were obtained. The 60-month follow-up (59 patients) revealed 57.6% cured and 25.4% improved patients. Mean urine loss was reduced significantly to 18.3 g (p < 0.001). A mean PGI score of 1.6 and a mean VAS score of 0.2 were obtained. Conclusions: The AdVance XP displays excellent continence results and secure effectiveness over a 5-year period. Moreover, these data are demonstrating low complication rates and improved quality of life in the long-term use of AdVance XP.

1.
Lucas
MG
,
Bosch
RJ
,
Burkhard
FC
,
Cruz
F
,
Madden
TB
,
Nambiar
AK
,
.
EAU guidelines on surgical treatment of urinary incontinence
.
Actas Urol Esp
.
2013
;
37
(
8
):
459
72
.
2.
Stanford
JL
,
Feng
Z
,
Hamilton
AS
,
Gilliland
FD
,
Stephenson
RA
,
Eley
JW
,
.
Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study
.
JAMA
.
2000
;
283
(
3
):
354
60
.
3.
Nam
RK
,
Herschorn
S
,
Loblaw
DA
,
Liu
Y
,
Klotz
LH
,
Carr
LK
,
.
Population based study of long-term rates of surgery for urinary incontinence after radical prostatectomy for prostate cancer
.
J Urol
.
2012
;
188
(
2
):
502
6
.
4.
Kumar
A
,
Litt
ER
,
Ballert
KN
,
Nitti
VW
.
Artificial urinary sphincter versus male sling for post-prostatectomy incontinence: What do patients choose
.
J Urol
.
2009
;
181
(
3
):
1231
5
.
5.
Hoy
NY
,
Rourke
KF
.
Stemming the tide of mild to moderate post-prostatectomy incontinence: a retrospective comparison of transobturator male slings and the artificial urinary sphincter
.
Can Urol Assoc J
.
2014
;
8
(
7–8
):
273
7
.
6.
Rehder
P
,
Gozzi
C
.
Transobturator sling suspension for male urinary incontinence including post-radical prostatectomy
.
Eur Urol
.
2007
;
52
(
3
):
860
6
.
7.
Rehder
P
,
Staudacher
NM
,
Schachtner
J
,
Berger
ME
,
Schillfahrt
F
,
Hauser
V
,
.
Hypothesis that urethral bulb (corpus spongiosum) plays an active role in male urinary continence
.
Adv Urol
.
2016
;
2016
:
6054730
.
8.
Kretschmer
A
,
Hübner
W
,
Sandhu
JS
,
Bauer
RM
.
Evaluation and management of postprostatectomy incontinence: a systematic review of current literature
.
Eur Urol Focus
.
2016
;
2
(
3
):
245
59
.
9.
Bauer
RM
,
Mayer
ME
,
May
F
,
Gratzke
C
,
Buchner
A
,
Soljanik
I
,
.
Complications of the AdVance transobturator male sling in the treatment of male stress urinary incontinence
.
Urology
.
2010
;
75
(
6
):
1494
8
.
10.
Bauer
RM
,
Mayer
ME
,
Gratzke
C
,
Soljanik
I
,
Buchner
A
,
Bastian
PJ
,
.
Prospective evaluation of the functional sling suspension for male postprostatectomy stress urinary incontinence: results after 1 year
.
Eur Urol
.
2009
;
56
(
6
):
928
33
.
11.
Papachristos
A
,
Mann
S
,
Talbot
K
,
Moon
D
.
AdVance male urethral sling: medium-term results in an Australian cohort
.
ANZ J Surg
.
2018
;
88
(
3
):
E178
82
.
12.
Bauer
RM
,
Grabbert
MT
,
Klehr
B
,
Gebhartl
B
,
Gozzi
C
,
Homberg
R
,
.
36-month data for the AdVance XP® male sling: results of a prospective multicentre study
.
BJU Int
.
2017
;
119
(
4
):
626
30
.
13.
Cornu
JN
,
Sèbe
P
,
Ciofu
C
,
Peyrat
L
,
Cussenot
O
,
Haab
F
.
Mid-term evaluation of the transobturator male sling for post-prostatectomy incontinence: focus on prognostic factors
.
BJU Int
.
2011
;
108
(
2
):
236
40
.
14.
Zemp
L
,
Tong
S
,
Hoy
N
,
Rourke
KF
.
Preoperative pad usage is independently associated with failure of non-adjustable male trans-obturator slings in otherwise well-selected patients
.
Can Urol Assoc J
.
2019
;
13
(
4
):
120
4
.
15.
Ye
H
,
Haab
F
,
de Ridder
D
,
Chauveau
P
,
Becker
A
,
Arano
P
,
.
Effectiveness and complications of the AMS AdVance male sling system for the treatment of stress urinary incontinence: a prospective multicenter study
.
Urology
.
2018
;
120
:
197
204
.
16.
Kretschmer
A
,
Grabbert
M
,
Sommer
A
,
Stief
CG
,
Bauer
RM
.
Mid-term outcomes after AdVanceXP male sling implantation
.
BJU Int
.
2016
;
118
(
3
):
458
.
17.
Bauer
RM
,
Rutkowski
M
,
Kretschmer
A
,
Casuscelli
J
,
Stief
CG
,
Huebner
W
.
Efficacy and complications of the adjustable sling system ArgusT for male incontinence: results of a prospective 2-center study
.
Urology
.
2015
;
85
(
2
):
316
20
.
18.
Bauer
RM
,
Gozzi
C
,
Klehr
B
,
Kretschmer
A
,
Grabbert
M
,
Rehder
P
,
.
AdVanceXP male sling: 2-year results of a multicentre study
.
World J Urol
.
2016
;
34
(
7
):
1025
30
.
19.
Grabbert
M
,
Mumm
JN
,
Klehr
B
,
Kretschmer
A
,
Gebhartl
P
,
Gozzi
C
,
.
Extended follow-up of the AdVance XP male sling in the treatment of male urinary stress incontinence after 48 months: results of a prospective and multicenter study
.
Neurourol Urodyn
.
2019 Sep
;
38
(
7
):
1973
8
.
20.
Bauer
RM
,
Kretschmer
A
,
Stief
CG
,
Füllhase
C
.
AdVance and AdVance XP slings for the treatment of post-prostatectomy incontinence
.
World J Urol
.
2015
;
33
(
1
):
145
50
.
21.
Bushnell
DM
,
Martin
ML
,
Summers
KH
,
Svihra
J
,
Lionis
C
,
Patrick
DL
.
Quality of life of women with urinary incontinence: cross-cultural performance of 15 language versions of the I-QOL
.
Qual Life Res
.
2005
;
14
(
8
):
1901
13
.
22.
Avery
K
,
Donovan
J
,
Peters
TJ
,
Shaw
C
,
Gotoh
M
,
Abrams
P
.
ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence
.
Neurourol Urodyn
.
2004
;
23
(
4
):
322
30
.
23.
Twiss
CO
,
Fischer
MC
,
Nitti
VW
.
Comparison between reduction in 24-hour pad weight, International Consultation on Incontinence-Short Form (ICIQ-SF) score, International Prostate Symptom Score (IPSS), and Post-Operative Patient Global Impression of Improvement (PGI-I) score in patient evaluation after male perineal sling
.
Neurourol Urodyn
.
2007
;
26
(
1
):
8
13
.
24.
Clavien
PA
,
Barkun
J
,
de Oliveira
ML
,
Vauthey
JN
,
Dindo
D
,
Schulick
RD
,
.
The Clavien-Dindo classification of surgical complications: five-year experience
.
Ann Surg
.
2009
;
250
(
2
):
187
96
.
25.
Bauer
RM
,
Gozzi
C
,
Roosen
A
,
Khoder
W
,
Trottmann
M
,
Waidelich
R
,
.
Impact of the ‘repositioning test’ on postoperative outcome of retroluminar transobturator male sling implantation
.
Urol Int
.
2013
;
90
(
3
):
334
8
.
26.
Dindo
D
,
Demartines
N
,
Clavien
PA
.
Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey
.
Ann Surg
.
2004
;
240
(
2
):
205
13
.
27.
Cornu
JN
,
Batista Da Costa
J
,
Henry
N
,
Peyrat
L
,
Beley
S
,
Haab
F
.
Comparative study of AdVance and AdVanceXP male slings in a tertiary reference center
.
Eur Urol
.
2014
;
65
(
2
):
502
4
.
28.
Soljanik
I
,
Bauer
RM
,
Stief
CG
,
Gozzi
C
,
Becker
AJ
.
Pelvic floor muscle function is an independent predictor of outcome after retrourethral transobturator male sling procedure
.
World J Urol
.
2015
;
33
(
8
):
1143
9
.
29.
Husch
T
,
Kretschmer
A
,
Thomsen
F
,
Kronlachner
D
,
Kurosch
M
,
Obaje
A
,
.
The AdVance and AdVanceXP male sling in urinary incontinence: Is there a difference
.
World J Urol
.
2018
;
36
(
10
):
1657
62
.
30.
Lai
HH
,
Hsu
EI
,
Teh
BS
,
Butler
EB
,
Boone
TB
.
13 years of experience with artificial urinary sphincter implantation at Baylor College of Medicine
.
J Urol
.
2007
;
177
(
3
):
1021
5
.
31.
Zuckerman
JM
,
Edwards
B
,
Henderson
K
,
Beydoun
HA
,
McCammon
KA
.
Extended outcomes in the treatment of male stress urinary incontinence with a transobturator sling
.
Urology
.
2014
;
83
(
4
):
939
45
.
32.
Bauer
RM
,
Gozzi
C
,
Klehr
B
,
Kretschmer
A
,
Grabbert
M
,
Rehder
P
,
.
AdVance XP male sling: 2-year results of a multicentre study
.
World J Urol
.
2016 Jul
;
34
(
7
):
1025
30
.
33.
Rehder
P
,
Haab
F
,
Cornu
JN
,
Gozzi
C
,
Bauer
RM
.
Treatment of postprostatectomy male urinary incontinence with the transobturator retroluminal repositioning sling suspension: 3-year follow-up
.
Eur Urol
.
2012
;
62
(
1
):
140
5
.
34.
Sturm
RM
,
Guralnick
ML
,
Stone
AR
,
Bales
GT
,
Dangle
PP
,
O’Connor
RC
.
Comparison of clinical outcomes between “ideal” and “nonideal” transobturator male sling patients for treatment of postprostatectomy incontinence
.
Urology
.
2014
;
83
(
5
):
1186
8
.
35.
Kowalik
CG
,
DeLong
JM
,
Mourtzinos
AP
.
The advance transobturator male sling for post-prostatectomy incontinence: subjective and objective outcomes with 3 years follow up
.
Neurourol Urodyn
.
2015
;
34
(
3
):
251
4
.
36.
Collado
A
,
Domínguez-Escrig
J
,
Ortiz Rodríguez
IM
,
Ramirez-Backhaus
M
,
Rodríguez Torreblanca
C
,
Rubio-Briones
J
,
.
Functional follow-up after Advance® and Advance XP® male sling surgery: assessment of predictive factors
.
World J Urol
.
2019
;
37
(
1
):
195
200
.
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