Absorbable sling enhances early continence after radical prostatectomy

Placement of an absorbable sling immediately after prostatectomy hastens the return of continence, according to a report in the June issue of Urology.

“These pilot data in patients at high risk of incontinence suggest that most men (even obese or older men) can have return of continence in days or weeks (and in many cases, immediately) instead of months,” Dr. J. Stephen Jones from Cleveland Clinic Foundation, Cleveland, Ohio told Reuters Health.Dr. Jones and colleagues evaluated the impact of using absorbable slings on the return to continence after radical retropubic prostatectomy in 15 men with prostate adenocarcinoma. Fifteen similar patients were used as controls.The first 5 sling patients recovered complete bladder control after a mean 5.8 weeks, the authors report, compared with 2.6 weeks for the last 10 patients with slings placed under enough tension to elevate the urethrovesical anastomosis slightly. Four patients in this latter group were dry within 24 hours.Ten sling patients were completely continent a month after catheter removal (including 8 patients, 80%, who had the sling placed under slight tension), the results indicate, compared with 6 of 15 (40%) control patients.All but one of the sling patients were dry 3 months later, the researchers note, compared with only 7 of the 15 control patients.Twelve control patients and 14 sling patients were dry after 6 months, the report indicates, and by 12 and 24 months all patients were dry except for one control patient.Placement of the sling added approximately 15 to 30 minutes to each procedure, the investigators report, but there were no complications associated with placement of the slings.”It is important to understand that most men eventually recover total continence following radical retropubic prostatectomy, so the impact of early return efforts will be primarily in the short term,” Dr. Jones explained. “However, even temporary incontinence is poorly tolerated by most men, so efforts to hasten return are important.””Although the risk of this procedure appears to be minimal based on data now 3-4 years mature, it still will most likely find its most appropriate use in men at high risk of incontinence,” Dr. Jones concluded.(Source: Urology 2005;65:1163-1167: Reuters Health: Oncolink: Will Boggs, MD: July 2005.)