The Male Perineal Sling Enhances the Distal Sphincteric Mechanism: Fluorourodynamic Study

Aims of Study The male perineal sling is a relatively new procedure for post prostatectomy incontinence that can be performed entirely through a perineal incision on an outpatient basis. Short-term results have been encouraging with 70% of patients becoming dry and another 10% showing improvement. (1) No urinary retention has been encountered. As with other sling procedures, the exact mechanism by which the male perineal sling restores continence is controversial. Clemens et al reviewed urodynamic results of their bulbourethral sling and concluded that, although Valsalva leak point pressures (VLPP) increased, resting urethral pressures did not change appreciably. (2) Functional urethral length was not included in their report. The objective of this study is to show the possible mechanisms behind the male perineal sling in achieving continence.