Prognostic value of postoperative urinary retention after male sling insertion

Introduction: While urinary retention is a known complication of AdVance male sling (AMS) placement for post-prostatectomy incontinence (PPI), there is minimal data regarding ultimate continence outcomes for patients who experience this complication. The purpose of this study was to determine the rate of continence after AMS placement in patients who had postoperative urinary retention as compared with those patients who did not. Materials and methods: A retrospective review was conducted of patients who underwent AMS placement for PPI between 2008 and 2011 with postoperative void trial (TOV). Preoperative factors such as urodynamic findings, daily pad number (PPD) and weight were recorded. Follow up data included pad use, need for catheterization and complications. Statistical analysis compared patients with and without postoperative urinary retention. Results: Thirty-five patients were included with a mean follow up of 11.8 months. Complete continence was 60%, while 83% of patients were improved. PPD improved from 2.9 pads to 0.8 pads after AMS placement. Sixteen patients (46%) had postoperative urinary retention requiring clean intermittent catheterization (CIC). Of the 16 patients in postoperative retention, 100% were completely continent (PPD = 0), compared to 5 of 19 patients (26%) who passed first TOV (p < 0.00001). All patients who required CIC were able to void within 7 days. Conclusions: Postoperative urinary retention after AMS placement for PPI occurs in about 50% of patients and is short-lived. Patients who experienced postoperative urinary retention had good continence outcomes.