Urinary Incontinence, Stress
Conditions
Keywords
Male Urethral Slings, Artificial Urinary Sphincter, Prostatectomy, Radiotherapy
Brief summary
Stress urinary incontinence is a significant potential source of morbidity after radical prostatectomy or radiation therapy for prostate cancer. At present, artificial urinary sphincter remains the preferred therapeutic option. However, this technique is not free from complications. In an attempt to avoid such complications, male sling has been suggested for use in patients with mild degrees of stress incontinence.
Detailed description
This is a prospective collection of pre-defined parameters on the treatment of male stress urinary incontinence by male sling or artificial urinary sphincter. This registry includes: 1. Pre-operative urodynamic assessment, cystoscopy and other preoperative clinical parameters (i.e. age, body mass index, bladder neck contracture treated, urgency, 24h-PW, cystometry and pressure/flow, repositioning test) 2. Description of surgical technique 3. Continence is evaluated 3 months after surgery, avoiding the potential confounding impact of the initial tissue edema (Cure was defined as no pad use, and all other cases were defined as failures) 4. Evaluation of long term functional outcome (efficacy, late complications and the loss of continence) Surgery is performed with: Device: Virtue® Device: Advance® and AdvanceXP® Device: Artificial urinary sphincter AMS-800® Device: Invance® Male Incontinence Sling A prospective functional follow-up, with 24h-Pad Weight test and ICIQ-UI SF, is carried out 3-monthly for the first year and 6-monthly thereafter, parallel to the oncological follow-up.
Interventions
PROCEDUREAMS-800
Artificial urianry sphincter
PROCEDUREADVANCE/ADVANCEXP
Male sling
PROCEDUREVIRTUE
Male sling
PROCEDUREINVANCE
Male sling
Sponsors
Fundación Instituto Valenciano de Oncología
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. The subject has agreed to be treated with the male Incontinence surgery devices 2. The subject is willing and able to give valid informed consent. 3. The subject is \> 18 years of age. 4. The subject has confirmed stress urinary incontinence for at least 12 months after prostatectomy or radiotherapy. 5. It has been confirmed the stress urinary incontinence with 24-Hour Pad Weight test 6. Pre-operative urodynamic assessment and flexible cystoscopy were performed in all cases 7. The subject is willing and able to return for follow-up evaluations and questionnaire completion according to the study protocol. 8. There are no surgical contraindications.
Exclusion criteria
1. The subject has an active urinary tract infection or active skin infection in region of surgery 2. The subject has serious bleeding disorders 3. The subject has unstable bladder neck stricture disease 4. The subject has Neurogenic bladder condition that is not treatable or controllable by pharmacological or alternative methods. 5. The subject has Detrusor-external sphincter dyssynergia. 6. The subject is unable or unwilling to sign the informed consent form (ICF)and/or comply with all follow-up requirements according to the study protocol 7. The subject is likely to undergo radiation therapy within the next 6 months 8. The subject has a history of connective tissue or autoimmune conditions. 9. The subject has a compromised immune system. 10. The subject has renal insufficiency, and upper and/or lower urinary tract relative obstruction. 11. The subject's reading level is judged inadequate for reading and understanding the quality of life questionnaires and other study materials
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Success rate | 3 months | Cure is defined as no pad use |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Continence improvement | 15 years | Assessed by means of the 24-Hour Pad Weight test |
| Lower tract urinary symptoms modification after male surgery incontinence | 15 years | Assessed with IPSS questionaires |
| Quality of Life in patients with male surgery incontinence | 15 years | Assessed with International Consultation on Incontinence Questionnaire -- Short Form (ICIQ-SF) questionaires |
Countries
Spain
Contacts
Primary ContactArgimiro Collado, MD, PhD
Outcome results
None listed