V3-04: Simple Male Urethral Sling Revision Technique

Video

Introductions and Objectives
Currently, failed male urethral slings may be treated with an artificial urinary sphincter or secondary sling. We describe a technique of revising an existing sling through a perineal incision and placing imbricating sutures to tighten the failed sling. We also give our initial clinical results.

Methods
A retrospective review was conducted of all patients from June 2010 to March 2013 who underwent a sling revision by a single surgeon. Ages, operative details, pad counts, and follow up information were collected and statistically analyzed for significance. A video describing the technique is made available.

Results
Sixteen patients were identified with a median age of 70 (43-78) years. The median daily pad count decreased from 4 to 1.3 with a p-value of 0.002. The median follow-up was 8 (0.6-16.1) months. The median operative time was 37 (20-76) minutes. There were no intraoperative complications and all patients were discharged home the same day without a urinary catheter. Seven patients became continent and three patients later underwent an uncomplicated artificial urinary sphincter.

Conclusions
Our video demonstrates that sling revision is a viable option for patients with a failed sling. It is a technically facile procedure that permits the patient to return home the same day with dramatically improved continence immediately. _x000D_ _x000D_ QUESTION:_x000D_ Dissection of the sling is done by:_x000D_ A. Mostly blunt dissection_x000D_ B. Mostly sharp dissection_x000D_ C. Electrocautery on "cut"_x000D_ D. Electrocautery on "coagulation" _x000D_ _x000D_ _x000D_ ***The views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.***

Funding: none