Questionnaire based results of the bulbourethral sling procedure

Purpose: The success rate of the bulbourethral sling procedure to treat post-radical prostatectomy incontinence has been reported in a previous chart review analysis. We present further evaluation of the procedure using postoperative mailed questionnaires. Materials and Methods: Between October 1994 and October 1997, 66 men underwent the bulbourethral sling procedure at our hospital. Postoperatively all patients with indwelling bolsters were mailed questionnaires to assess continence status, discomfort and voiding patterns. Results: Of the 66 patients 4 required bolster removal for infection (2), erosion (1) or pain (1), and 1 died. These patients were not assessed further. Questionnaire data were obtained from the remaining 61 patients. At a median followup of 9.6 months (mean 11.9, range 3 to 30) 25 patients (41%) reported complete cure of incontinence, 32 (53%) required no pad for protection and 52 (85%) required 2 pads or less. Persistent perineal numbness or discomfort was present in 32 patients (52%). Of 12 patients who received adjuvant radiation therapy only 1 (8%) was cured. Conclusions: The short-term success rate following the bulbourethral sling procedure is high but persistent perineal discomfort is common. Adjuvant radiation predisposes to treatment failure.