The male sling for post‐prostatectomy urinary incontinence: a review of contemporary sling designs and outcomes
Bibliographic record
Abstract
What's known on the subject? and What does the study add? Long‐term cure and improved rates for the bone anchored sling range from 40–88%. Midterm cure and improved rates for the retrourethral transobturator sling rage from 76–91%. Midterm cure and improved rates for the adjustable retropubic sling rage from 72–79%. Potential complications common to all urethral slings include postoperative urinary retention, perineal pain, and urethral erosion/device infection. All male urethral slings have primarily been studied in post radical prostatectomy patients, with inconsistent success among patients with prior pelvic radiation. OBJECTIVE To examine the outcomes and adverse events associated with novel male sling designs described in the last decade. METHODS A literature review was carried out using Medline, EmBase, Cochrane Registered Trials Database and the Center for Reviews and Dissemination Database. RESULTS Three principal slings are described in the literature. The bone‐anchored sling has success rates of 40–88%, with some series having a mean follow‐up of 36–48 months. It is associated with a mesh infection rate of 2–12%, which usually requires sling explantation. The retrourethral transobturator sling has a success rate of 76–91% among three large case series with follow‐ups of 12–27 months. There is a low reported explantation rate. The adjustable retropubic sling has a success rate of 72–79% with follow‐ups of 26–45 months. Erosion (3–13%) and infection (3–11%) can lead to explantation. CONCLUSIONS Most male slings have a similar reported efficacy. Most case series define success as either dry or improved. True cure rates are lower. Mid‐ and long‐term data are now available that indicate the male sling is a viable option for PPI. The use of male slings in severe UI, radiated patients, and non‐radical prostatectomy patients is still unclear. Further study is needed to try and define criteria for the use of male slings, and to directly compare different procedures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".