***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND The AdVance male sling ( American Medical Systems , Minnetonka , MN , USA ) has been shown to be an efficacious device in short-term studies for postprostatectomy incontinence ( PPI ) , but long-term studies are lacking . OBJECTIVE Examine the intermediate-term outcome with the AdVance sling for PPI management . DESIGN , SETTING , AND PARTICIPANTS A multicentre prospect i ve evaluation was conducted on consecutive patients treated for PPI in three European tertiary reference centres . INTERVENTION Patients were implanted with the AdVance male sling with no associated surgery . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Measurements included daily pad usage , maximum flow rate ( Qmax ) , postvoid residual urine ( PVR ) , the International Consultation on Incontinence Question naire-Short Form , the Incontinence Quality of Life question naires , and complications of surgery . Paired Wilcoxon signed rank test univariable and multivariable analyses were used . RESULTS AND LIMITATIONS Follow-up was available for 156 patients for the majority of parameters . Pad usage was significantly decreased compared with baseline at 12 mo and 3 yr ( p<0.0001 ) . At 12 mo , 76.9 % of patients could be classified as cured or improved ; this percentage was maintained at 3 yr ( 76.8 % ) . Cure rates ( 58.6 % vs 42.3 % ) and improvement rates ( 23.2 % vs 25.0 % ) were higher in patients with mild or moderate incontinence compared with severe incontinence . Univariable analysis showed that pretreatment pad usage and severity of incontinence were both significant predictors of success ( p=0.0355 and p=0.0420 , respectively ) . However , in multivariable analysis , only pad usage was an independent predictor of success . There were no perioperative or severe postoperative complications . Most complications were Dindo grade I. Seven patients required a second treatment for stress urinary incontinence . There was no worsening over time . Limitations of this study included no comparator group , quality of life question naires in only two centres , and no 24-h pad test . CONCLUSIONS The transobturator retroluminal repositioning sling suspension is effective and safe in the longer term for treating PPI OBJECTIVE Description and early results of a new urethral sling technique for treatment of postprostatectomy urinary incontinence , which combines efficacy , low cost and technical simplicity . MATERIAL S AND METHODS From May 2003 to April 2004 , 30 patients with moderate or total urinary incontinence , following radical prostatectomy or endoscopic resection of the prostate , underwent the new technique . The technique is based on the placement of a longitudinal-shaped sling in the bulbar urethra , measuring 4 cm in length by 1.8 cm in width , made of Dacron or polypropylene mesh , fixed by 4 sutures on each side , with 2 sutures passed with Stamey-Pereira needle by retropubic approach and 2 by prepubic approach , which are then tied over the pubis . Pressure control was determined by interrupting the loss of infused water through a suprapubic cystostomy 60 cm from the pubis level . RESULTS Pre-operative assessment excluded vesical instability , urethral stenosis and urinary infection . Suprapubic cystostomy was removed when the patient was able to satisfactorily void with urinary residue lower than 100 mL , which occurred in 29 of the 30 cases . In 2 cases , there was infection of the prosthesis , requiring its removal . In 3 cases , there was the need to adjust the sling ( increasing the tension ) , due to failure of the urinary continence . Overall , 20 of 30 ( 66.7 % ) operated patients became totally continent , and did not require any kind of pads . Four of 30 ( 13.3 % ) patients achieved partial improvement , requiring 1 to 2 pads daily and 6 of 30 ( 20 % ) patients had minimal or no improvement . There was no case of urethral erosion . CONCLUSION This new sling technique has shown highly encouraging preliminary results . Its major advantage over other surgical techniques for treatment of moderate or severe stress urinary incontinence is the simplicity for its execution and low cost . A long-term assessment , addressing maintenance of continence , detrusor function and preservation of the upper urinary tract , is still needed PURPOSE The male perineal sling has become an option for treating male stress incontinence . We evaluated its overall efficacy and determined preoperative parameters that could predict success . MATERIAL S AND METHODS A total of 62 men with stress incontinence were prospect ively evaluated and underwent a male perineal sling . Preoperatively 24-hour pad weight , urodynamics and a number of vali date d incontinence question naires were completed . At a minimum of 3 months of followup 24-hour pad weight and question naires were repeated . Success was assessed using the 1 question Patient Global Impression of Improvement . The Patient Global Impression of Improvement was compared to a number of other subjective and objective measures of outcome . Finally , preoperative parameters were evaluated to determine predictors of outcome . RESULTS As determined by the Patient Global Impression of Improvement , the success rate was 58 % . The only preoperative factor predictive of success was 24-hour pad weight . An individual had a 71 % chance of successful surgery if preoperative pad weight was less than 423 gm . There was a statistically significant difference between successes and failures in terms of postoperative pad weight and certain question naires , including the UCLA/R AND Prostate Cancer Index urinary function score , International Consultation on Incontinence short form , Incontinence Impact Question naire , Urogenital Distress Index and International Prostate Symptom Score . The overall complication rate was 21 % and the reoperation rate was 14.5 % . CONCLUSIONS The male perineal sling can be an effective surgical treatment for stress incontinence in the appropriate patient . The procedure is most successful in patients with lesser objective degrees of incontinence . The Patient Global Impression of Improvement is an effective tool for assessing outcome for this population PURPOSE A new bulbourethral sling procedure is proposed for patients with post-radical prostatectomy incontinence . MATERIAL AND METHODS Bulbourethral composite suspension was performed in 16 consecutive patients , of whom 6 ( 38 % ) had severe stress incontinence and depended on a condom urinal catheter . Urinary stress incontinence was assessed preoperatively by a modified pad test , urethrocystoscopy and urodynamic evaluation . The procedure was performed with a longitudinal perineal and a transverse suprapubic incision with the patient under regional anesthesia . We placed a porcine dermis for urethral protection and a polypropylene retropubic sling , which was tied suprapubically with the patient coughing and during retro grade urethral closure pressure monitoring at 60 cm H2O . RESULTS Preoperative evaluation excluded detrusor instability and urethral stricture . The polypropylene b and was placed without neurogenic or vascular complications . All patients had primary wound healing . Patients reported only minimal postoperative pain . Clinical followup was performed a median of 14 months postoperatively ( range 6 to 32 ) . Of the 16 patients 11 ( 69 % ) were completely dry and 1 ( 6 % ) reported improved continence , while 4 ( 25 % ) had no benefit , including 2 who underwent an artificial sphincter procedure . Preoperative mean daily pad use decreased from 7 ( range 2 to 12 ) to 1 ( range 0 to 10 ) postoperatively ( p = 0.0004 ) and postoperative quality of life improved significantly ( p < 0.0001 ) . CONCLUSIONS Bulbourethral composite suspension is a new , efficient operative sling technique in patients with severe post-prostatectomy stress urinary continence . Because morbidity and complications are low , this new technique may become an alternative to artificial urinary sphincter implantation . Long-term observation of urethral and detrusor function is necessary to eluci date the specific contribution of bulbourethral composite suspension in restoring urinary continence after radical prostatectomy OBJECTIVES To compare how urinary symptoms affect the quality of life in groups of men with postprostatectomy incontinence treated with collagen versus artificial urinary sphincter implantation .  METHODS Two cohorts of men , one which received urethral collagen injection and one artificial urinary sphincter ( AUS ) implantation  , were surveyed with a vali date d quality -of-life question naire to assess how their urinary dysfunction impacted their daily activities . The mean impact score and bother score for the two groups were compared . In addition , the overall degree of continence between the groups was assessed . RESULTS At a mean follow-up of 19 months , 8 ( 20 % ) of 41 patients treated with collagen injections were at least socially continent , requiring one pad daily or less . In comparison , 27 ( 75 % ) of 36 men treated with an AUS were at least socially continent ( P < 0.001 ) . Both the impact score and the bother score from the quality -of-life question naire were significantly lower in the group treated with the AUS than in the group treated with collagen . CONCLUSIONS Patients receiving an AUS achieved significantly higher continence rates . Also , the quality of life of men treated with an AUS was improved compared with that of the men treated with collagen injection PURPOSE This is a report of a prospect i ve study of the male sling for treating stress urinary incontinence . MATERIAL S AND METHODS A total of 21 men underwent sling surgery .  There were 2 titanium screws loaded with polypropylene suture placed in each descending pubic ramus through a 3.5 cm . perineal incision at the level of the bulbar urethra . A polypropylene mesh was placed over the urethra and tied to the bone anchors , adjusting sling tension to a compression pressure of 60 cm . water . Followup was done with the incontinence section of the University of California , Los Angeles/R AND Prostate Cancer Index . RESULTS Mean followup was 12 months ( range 5 to 21 ) . Overall , incontinence was cured in 16 ( 76 % ) patients , substantially improved ( stress urinary incontinence very small or small problem , 1 pad daily ) in 3 ( 14 % ) , somewhat improved ( moderate problem-2 pads ) in 1 and procedure failed ( no improvement ) in 1 ( 5 % ) . The patients with stress urinary incontinence after undergoing transurethral prostatectomy were cured , as was the individual with myelomeningocele . Of the 18 patients with stress urinary incontinence after radical prostatectomy 13 were cured , including 1 of 2 who underwent previous artificial urinary sphincter placement and 2 of 3 adjuvant radiation . There was significant improvement in each survey question , and the total score improved from a mean plus or minus st and ard deviation of 65 + /- 11 preoperatively to 397 + /- 29 postoperatively ( p < 0.001 ) . There was no retention , infection , erosion or de novo voiding dysfunction . CONCLUSIONS This minimally invasive sling surgery has not been associated with any significant complication , and early results compare favorably with artificial urinary sphincter . By compressing only the ventral urethra the risk of urethral erosion and atrophy is reduced . Prior radiation or artificial urinary sphincter does not appear to be a contraindication to sling surgery OBJECTIVES To prospect ively evaluate the efficacy of the functional AdVance transobturator sling for the treatment of male stress urinary incontinence ( SUI ) in patients after radical prostatectomy and additional adjuvant radiotherapy .  METHODS Between February 2007 and November 2008 , 24 patients with postprostatectomy SUI ( ICS grade 2 - 4 ) and additional adjuvant radiotherapy were treated consecutively with the AdVance sling . Preoperatively , intensive workup , including urodynamic assessment and flexible urethroscopy , was performed . Physical examinations ( pad test , uroflowmetry , ultrasound ) and question naires ( I-QOL score , ICIQ-UI-SF score ) were performed during baseline and during follow-up . Cure rate was defined as no pad use or one dry pad , and improved rate as 1 - 2 pads or reduction of pads by ≥50 % . RESULTS After a median follow-up of 18.0 months ( range 12 - 33 months , mean 18.8 months ) , the success rate was 50 % . Daily pad use and pad weight in the 1-hour pad test decreased significantly . Patients with ICS grade 2 SUI exhibited a trend for a better success rate in comparison with patients with grade 3 and 4 SUI . Results were durable over time . Postoperatively , 16.7 % of the patients exhibited transient acute urinary retention which resolved without further treatment after a maximum of 6 weeks . 1 sling had to be removed because of initial misplacement . CONCLUSIONS In selected patients after adjuvant radiotherapy , the AdVance sling achieved a success rate of 50 % and results were stable in a median follow-up of 18 months . Complication rates were low and comparable to complication rates for patients without additional radiotherapy OBJECTIVE To prospect ively evaluate the efficacy and tolerability of the I-STOP TOMS trans 
    Output:
    
Our findings indicate that both sling and artificial urinary sphincter interventions are effective in reducing incontinence and improving the patient 's quality of life