„Male slings“ – eine Übersicht
摘要
Surgical management of male stress urinary incontinence following prostatectomy includes fixed and adjustable male slings as well as the artificial urinary sphincter. Owing to high revision rates of the sphincter and strong patient preference, passive sling systems have gained increased clinical relevance. Fixed slings are primarily indicated in men with mild to moderate incontinence and preserved residual sphincter function, whereas adjustable slings serve as an intermediate option for patients with more severe leakage or prior radiotherapy. Although the overall level of evidence is limited by heterogeneous inclusion criteria and the lack of randomized controlled trials, meta-analyses demonstrate meaningful improvements in continence and quality of life in appropriately selected patients. Adjustable systems permit postoperative readjustment and may compensate for long-term deterioration but are associated with higher revision and complication rates. Careful patient selection based on clinical history, urethroscopy, and urodynamic assessment remains essential to optimize outcomes.