Artificial Urinary Sphincter Outperforms Sling for Moderate Male Stress Urinary Incontinence

Academic Article


  • Objectives: To determine the role of slings and artificial urinary sphincters (AUS) in the management of mild and moderate stress urinary incontinence (SUI). Methods: A retrospective review of our single-surgeon male SUI database was completed. Men having AUS or AdVance sling procedures between 2008 and 2019 were included in the analysis. Those with severe incontinence and/or incomplete pre- or postoperative data were excluded. All patients were evaluated by standing cough test and stratified according to the Male Stress Incontinence Grading Scale. Scores of 0-1 and 2-3 defined mild and moderate SUI, respectively. We performed 2 analyses: (a) sling outcomes were compared between mild vs moderate SUI patients, and (b) for men with moderate SUI, we compared outcomes between slings and AUS. Treatment failure was defined as >1 pad per day or need for subsequent incontinence procedure. Results: Among 202 sling cases, those with mild SUI had significantly higher success rate (69/88, 78%) than those with moderate SUI (72/114, 63%; P = .02). Among the 179 men with moderate SUI, those who underwent AUS had significantly higher success rate (52/65, 80%) than those who underwent sling (72/114, 63%; P = .02). Conclusion: Male slings are more effective for men with mild SUI than for men with moderate SUI. Men with moderate SUI have a higher success rate with AUS than with sling.
  • Authors

    Published In

  • Urology  Journal
  • Digital Object Identifier (doi)

    Pubmed Id

  • 17957077
  • Author List

  • Khouri RK; Ortiz NM; Baumgarten AS; Ward EE; VanDyke ME; Hudak SJ; Morey AF
  • Start Page

  • 168
  • End Page

  • 172
  • Volume

  • 141