Transobturator male sling: is there a learning curve?

Introduction: A potential learning curve associated with AdVance (American Medical Systems, Minnetonka, MN, USA) sling placement has not been adequately reported.

Materials And Methods: Retrospective analysis of our AdVance single surgeon database. Patients with a history of a radical prostatectomy, no past radiation or prior incontinence interventions and at least 12 months of follow up were included. A learning curve was evaluated by predicting patient outcomes using their order within the surgical log. Univariate and multivariate logistic regressions were performed.

Results: Sixty patients with mean age of 65 years and an average 28.2 months of follow up were included in the analysis. Surgical order was not significant on either univariate or multivariate analysis for predicting outcomes following sling placement. Patients with a history of a retropubic radical prostatectomy did enjoy improved incontinence results at all time points tested. Other variables were mixed.

Conclusion: Our data failed to demonstrate a significant surgical learning curve that would predict outcomes following AdVance sling placement.