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Hi, in this video we'll talk about a surgical treatment option for male stress urinary incontinence
after prostate surgery, namely the advance male sling, this treatment has been gaining
a gradual popularity since its introduction in 2006 in Austria by Peter Rehder and Christian
Gozzi, due to its minimal invasiveness and its simplicity, it is usually offered for
patients with mild to moderate urinary incontinence after prostate surgery which is usually defined
by the number of pads patients use, so if patients use between one to two pads they
are considered to have mild incontinence and if they use between three to four pads they
are considered to have moderate incontinence, so the male sling is usually offered for these
two types of patients, in this video we will talk specifically about the male sling, so
we'll talk about what is the male sling made of, at what point after prostate surgery it's
usually offered for patients, how the operation is done, how does the male sling work, and
then we'll talk specifically about the success rates of the male sling and the complication
rates, and then we'll finally address two specific points which are the outcome of the
male sling in patients with severe urinary incontinence and also the outcome of the male
sling in patients who previously had radiotherapy, the AdVance male sling is usually offered
as early as six months after the prostate surgery to patients who are still leaking
urine after surgery, but the majority of patients wait until 12 months, trying other conservative
treatment options like the pelvic floor exercises or some medical treatments.
so
as shown in the previous picture, the
needle passer goes through the obturator foramen, it's a spherical shaped needle, so the needle
goes through the obturator foramen and comes out from the perineal area, then the sling
is attached to the end of the needle, and the needle is pulled back again so the sling
goes through those tissues that the needle had passed through, which mainly include the
obturator muscle which is the muscle that fills the obturator foramen or the obturator
opening, and the fibrous tissue that surrounds the muscle, and the same thing is done on
the other side, and then both arms of the sling are tightened, it's like pulling on
your cheeks like that, so a kind of pressure is applied from underneath and behind the
bulbar urethra to reposition
it
to the normal
anatomical position. I hope you found this video useful so far,
in the next video we will talk about the success rate of the male sling and the complication
rates and then we'll talk about the outcome of the male sling in patients with severe
urinary incontinence and also the outcome of the male sling in patients with previous
radiotherapy treatment, and thank you very much for taking the time to watch this video.