J. Neymeyer, T. Wülfing, W. Abdul-Wahab Al-Ansari, A. Apostolidis, J. Neymeyer, T. Wülfing, W. Abdul-Wahab Al-Ansari, A. Apostolidis, S. Kassin und M. BeerS. Kassin und M. Beer

Abteilung für Urologie und Urogynäkologie, Franziskus-Krankenhaus-BerlinAbteilung für Urologie und Urogynäkologie, Franziskus-Krankenhaus-Berlin

Enhancing outcomes of suburethral sling operations Enhancing outcomes of suburethral sling operations in males by using suburethralin males by using suburethral

Introduction and Objective:

- suburethral sling procedures have reduced loss of urine by 50 to 80%- additional suburethral injections of hyaluronic acid we aimed to further enhance the clinical outcomes of these patients

Methods:

- 26 patients who underwent male sling procedures to correct SUI secondary- suburethral of hyaluronic acid injections at the site of the external urethral sphincter

Results:

- we already know that the male urethral sling improves SUI by 50 to 80%. - with additional treatment of suburethral injections there is an even further improvement of 20% meaning patients with grade II & III SUI use an average of 0 to 1.5 pads per day.

Conclusions:

- additional Hyaluronic Acid suburethral injections reducing the daily use of pads from 5 pads to anywhere between 0 to 1.5 pads per day among- for secondary additional suburethral injections you can use non-resorble Materials like Bulkamid for better long term results

Author’s opinion - Treatment recommendation:

Franziskus-Krankenhaus-BerlinFranziskus-Krankenhaus-BerlinAbteilung für Urologie und UrogynäkologieAbteilung für Urologie und Urogynäkologie

Akademisches Lehrkrankenhaus der Charité, Universitätsmedizin – BerlinAkademisches Lehrkrankenhaus der Charité, Universitätsmedizin – Berlin

Treatment recommendation:- Transobtoratory Inside-Out-Technique- Thread to bring forward for inserting the Mesh- Tension-Mesh-Fixation with resorbable Clips- Subcutaneous, post-operative volume adjustment

Conclusions:- Male sling procedures might be an efficient SUI (°I) treatment option after radical prostatectomy and TURP.- The combination of TiLOOP Male Sling with the adjustable Balloon-System ProAct™ already provides an alternative and effective new treatment option for patients with SUI (°II and °III).- The sling is performed minimally invasive, feasible and allows for an immediate improvement of incontinence after catheter removal on the second postoperative day. - Minimal invasive late regulation is possible. Despite the fact that the majority of patients still use a single pad for safety reasons after the treatment, their satisfaction is high. - Side effects are mild.

The TiLOOP Male Sling System or the combination Sling and adjustable Balloon-System completes the spectrum of minimal invasive incontinence surgical procedures.