Enhancing outcomes of suburethral sling operations in males by using suburethral J. Neymeyer, T. Wülfing, W. Abdul-Wahab Al-Ansari, A. Apostolidis, S. Kassin und M. Beer Abteilung für Urologie und Urogynäkologie, Franziskus-Krankenhaus-Berlin

Introduction and Objective: - suburethral sling procedures have reduced loss of urine by 50 to 80% - additional suburethral injections of hyaluronic acid we aimed to further enhance the clinical outcomes of these patients Methods: - 26 patients who underwent male sling procedures to correct SUI secondary - suburethral of hyaluronic acid injections at the site of the external urethral sphincter Results: - we already know that the male urethral sling improves SUI by 50 to 80%. - with additional treatment of suburethral injections there is an even further improvement of 20% meaning patients with grade II & III SUI use an average of 0 to 1.5 pads per day. Conclusions: - additional Hyaluronic Acid suburethral injections reducing the daily use of pads from 5 pads to anywhere between 0 to 1.5 pads per day among - for secondary additional suburethral injections you can use non-resorble Materials like Bulkamid for better long term results

Author’s opinion - Treatment recommendation:

Akademisches Lehrkrankenhaus der Charité, Universitätsmedizin – Berlin Franziskus-Krankenhaus-Berlin Abteilung für Urologie und Urogynäkologie Akademisches Lehrkrankenhaus der Charité, Universitätsmedizin – Berlin

Treatment recommendation: - Transobtoratory Inside-Out-Technique - Thread to bring forward for inserting the Mesh - Tension-Mesh-Fixation with resorbable Clips - Subcutaneous, post-operative volume adjustment Conclusions: Male sling procedures might be an efficient SUI (°I) treatment option after radical prostatectomy and TURP. - The combination of TiLOOP Male Sling with the adjustable Balloon-System ProAct™ already provides an alternative and effective new treatment option for patients with SUI (°II and °III). - The sling is performed minimally invasive, feasible and allows for an immediate improvement of incontinence after catheter removal on the second postoperative day. - Minimal invasive late regulation is possible. Despite the fact that the majority of patients still use a single pad for safety reasons after the treatment, their satisfaction is high. - Side effects are mild. The TiLOOP Male Sling System or the combination Sling and adjustable Balloon-System completes the spectrum of minimal invasive incontinence surgical procedures.