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Introduction:
The efficacy of the AdVance transobturator male sling for post-prostatectomy incontinence has been questioned in patients with a history of pelvic radiation. Furthermore, there exists limited data on long-term follow-up and durability of this procedure.
Materials & Methods:
We performed a retrospective chart review and follow-up surveys of all patients who underwent a post-prostatectomy sling placement for urinary incontinence from 2007 to present. Severity of urinary incontinence was determined by PPD use. Patient satisfaction was determined by willingness to recommend the procedure to a friend. Outcomes were compared between radiated and non-radiated men at both short-term and long-term follow-up intervals.
Results:
Fifty-two men underwent AdVance Sling placement at our institution from 2007 to present; 18 men had a history of adjuvant radiation. Thirty-six and 16 men were available for short-term (mean 19.4mo) and long-term (mean 61.5 mo) postoperative interviews, respectively. Overall, PPD use improvement was seen in both groups. However, patient satisfaction and efficacy decreased with time in both groups, to a much greater degree in radiated patients (Table 1).
Conclusions:
The majority of patients undergoing AdVance sling placement for post-prostatectomy incontinence saw a reduction in PPD use, and were overall satisfied in both groups at short- and long-term follow-up. The improvements were more pronounced in the non-radiated group. Therefore, the AdVance sling is markedly a more efficacious and durable intervention in radiation-naive patients.

	Radiation (n=14)	Non-Radiation (n=22)	P Value
Short-Term Improvement in PPD	1.1 (3 to 1.9ppd)	2.3 (3.3 to 1ppd)	<0.05
Short-Term Patient Satisfaction	64%	95%
	Radiation (n=6)	Non-Radiation (n=10)
Long-Term Improvement in PPD	0.8 (3 to 2.2)	1.55 (3.3 to 1.75)	0.09
Long-Term Patient Satisfaction	33%	80%