Early results of transobturator sling suspension for male urinary incontinence following radical prostatectomy.

Aside from erectile dysfunction, urinary incontinence continues to present a major adverse event following radical prostatectomy. Large surgical series present incontinence rates of up to 20%. The increased understanding of pelvic anatomy has lead to a decrease in the incontinence rate, whereas the true rate may even be higher. In recent years, novel treatment options have been introduced [1–5]. Besides medical treatment for stress incontinence, several surgical techniques have been reported for different forms of stress urinary incontinence (SUI) [4]. Besides other innovations, Rehder et al presented the transobturator sling suspension (AdVance) [1]. Due to the rapid progress in this field, we want to provide an update on early continence results of this novel surgical technique. We present 67 consecutive patients with SUI following radical prostatectomy undergoing this novel approach at our institution. Surgery was performed as previously described [1]. Briefly, a polypropylene tape is placed under the membranous urethra using a transobturator approach. During the procedure, the tape is selfanchored due to the woven nature of the tape. Because the tape does not circle the membranous urethra but points away from it, tensioning the tape leads to replace the posterior bulbar surface parallel to the membranous urethral lumen. This mechanism reduces the risk of urethral erosion and supports the hammock-like support of the posterior sphincter complex. In the initial report of four cadaver cases and 20 male patients with SUI following different treatments for prostatic diseases, we demonstrated the feasibility of the surgical techniques [1]. The postoperative results included the improvement of