The AdVance® Male Sling: Patient Selection and Workup

The AdVance® male sling (American Medical Systems, Minnetonka, MN, USA) is a retrourethral transobturator sling that offers an effective surgical approach for the treatment of postprostatectomy stress urinary incontinence (SUI). Clinical studies have demonstrated success rates of 80–90% at 1-yr follow-up. The most appropriate candidate patients for the AdVance® sling may be those with mild to moderate incontinence, but success rates may not be markedly lower in patients with severe incontinence. Clinical experience with the AdVance® sling suggests that cystoscopically confirmed residual sphincter function is an important requirement for good outcome. Assessment of SUI should be modified to include a consideration of sphincter function in addition to the currently accepted definitions of incontinence severity (pad weight and number). The AdVance® male sling may be considered a first-line surgical treatment as well as a salvage treatment for some patients who have failed previous surgical treatment. More data are needed to better understand the patient-related factors that affect the short- and long-term outcomes of this minimally invasive treatment for male SUI.