AdVance™ XP male sling implantation for stress urinary incontinence after orthotopic ileal neobladder reconstruction
https://orcid.org/0009-0007-7168-5499
Mattia Lo Re
https://orcid.org/0009-0006-4589-8936
Elettra Fuligni
Gianni Vittori
Malte W. Vetterlein
Paul Neuville
https://orcid.org/0000-0002-0241-021X
Andrea Minervini
Andrea Cocci
https://orcid.org/0000-0003-0138-6294
Abstract
Stress urinary incontinence (UI) after radical cystectomy with orthotopic ileal neobladder reconstruction remains a challenging condition in men, with very limited evidence regarding surgical management. Specifically, experience with male sling implantation in this setting is limited to a few published cases. We report a 63-year-old male with mixed UI using three pads per day and ICIQ-SF 15, unresponsive to conservative therapy. An AdVance™ XP sling was implanted via transobturator approach. At six months, pad use decreased to 1–2 per day and ICIQ-SF improved to 7, with complete resolution of the stress component and persistence of urgency UI alone. Post-void residual volumes remained low, and no complications were observed. Male sling implantation may represent a less invasive alternative to the artificial urinary sphincter in carefully selected patients, although careful tensioning is essential to avoid urinary retention. This case adds to the scarce published evidence supporting the feasibility of AdVance™ XP sling implantation in men with orthotopic ileal neobladders, although further studies are needed to confirm its long-term safety and effectiveness.
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stress urinary incontinence, male urethral sling, orthotopic ileal neobladder, radical cystectomy, artificial urinary sphincter, urinary diversion
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