Redesigned Mesh Sling System Treats Male Urinary Incontinence

A surgically implanted mesh sling system helps relieve stress urinary incontinence (SUI) in men by compressing and supporting the urethra, helping the bladder to fully close.

The Boston Scientific (Natick, MA, USA) AdVance XP Male Sling System is designed to place a SUI suburethral/retrourethral sling using a transobturator placement technique. Patients may be continent immediately after the procedure, and most resume normal daily activities one to two weeks later. The sling itself, which acts as a hammock that repositions and supports the urethra, features a heat-sealed edge for fixation and a polypropylene liner that reduces pull-through resistance during sling passage, enabling desired sling placement prior to fixation.

Other components of the system include needle passers shaped in a helical form designed specifically for transobturator needle passage in the male anatomy, with arrows that indicate on which side of the patient’s body they should be used; percutaneous needles to assist in the identification of the correct obturator foramen needle passer entry point; a chevron anchoring mechanism; a resorbable tensioning suture that increases the tensile strength of the sling; and a disposable retractor system consisting of a retractor ring and blunt stay hooks that assists with surgical retraction and increases field of view.

“The AdVance XP Sling will help restore urinary control to men who have unfortunately suffered SUI from previous prostate removal. This new sling has some design modifications which will help make our already excellent results even better,” said urologist Richard Kershen, MD, of Tallwood Urology & Kidney Institute (Hartford, CT, USA). “Patients are extremely happy with the change the sling system brings them. They are often fully continent immediately after the procedure and can get back to most activities in four to six weeks.”

SUI is the loss of bladder control or involuntary loss of urine when coughing, laughing, sneezing, or during heavy lifting, or simply getting up from a chair. SUI is the most common type of incontinence suffered by women, especially older women and women who have given birth. While less common in men, SUI occurs in about 15% of men over the age of 60, especially following prostate surgery.