Skip to main content

AdVance / AdVance XP — Retrourethral Transobturator Male Sling

The AdVance male sling (originally American Medical Systems, now Boston Scientific) is a retrourethral transobturator polypropylene mesh sling for mild-to-moderate post-prostatectomy stress urinary incontinence (PPI). It was first described by Rehder & Gozzi in 2007 and is among the most extensively studied male slings. The second-generation AdVance XP (2010) added changes to the sling design and a new needle shape.[1][2][3]

For positioning versus other male slings and the AUS, see Male Urethral Slings — chooser.

Mechanism​

Retrourethral repositioning. The AdVance sling repositions the bulbar urethra proximally to augment residual sphincter coaptation. The XP IFU targets this movement without luminal compression, and dynamic MRI has shown increased functional urethral length at rest after transobturator sling placement.[2][26][4] A dynamic-MRI study lengthened the vesicourethral-anastomosis-to-bulbar-urethra distance at rest from 1.27 cm before the sling to 1.53 cm after it (17 men after sling). Continent post-prostatectomy controls measured 1.92 cm; the difference from controls was significant before the sling (P = 0.0018) and no longer significant after it (P = 0.09).[4]

The AdVance augments the residual sphincter and does not replace it, so residual sphincter function must be present.

AdVance vs AdVance XP​

Hüsch 2018 compared 109 AdVance and 185 AdVance XP slings (retrospective complication data, prospective questionnaires). Functional outcomes (ICIQ-SF, PGI, I-QoL, pad usage) did not differ between the two generations. Postoperative urinary retention was significantly more frequent with the XP (p = 0.042).[5]

Patient selection — the "repositioning test"​

Performed during flexible cystoscopy preoperatively. With gentle midperineal pressure elevating the posterior urethra, assess sphincter closure at rest and during voluntary pelvic-floor contraction; in Bauer’s protocol, a positive test required complete concentric closure and coaptive-zone lengthening of ≥ 1 cm during active contraction.[38] Earlier AdVance/XP reports used visible sphincter contraction and a positive repositioning test as selection criteria.[2][3] An unfavorable repositioning test has been associated with lower fixed-sling success in observational studies, but cystoscopic sphincter assessment showed limited interobserver agreement (ICC 0.31–0.53 across observer groups in a 37-recording study).[6][33][39] In the Soljanik series, weak residual sphincter function with incomplete sphincter closure carried an OR of 29.0 for failure.[6]

Additional standard selection criteria:

  • Assess nighttime and resting leakage; even in severe SUI, where the AUA guideline advises against routine slings, it says clinicians might consider a sling in men with minimal nighttime incontinence.[28]
  • Before AdVance XP implantation, treat urinary infection and review IFU contraindications: coagulation disorder, compromised immunity or healing, and renal insufficiency with relative upper-tract obstruction. The IFU recommends bladder capacity >250 mL, postvoid residual <50 mL, and exclusion of bladder-neck or urethral stricture, cystitis, urethritis, prostatitis, and neurologic detrusor instability. Assess urgency symptoms; the IFU also recommends six months of noninvasive treatment before considering a sling.[26]
  • No prior incontinence surgery (relative)
  • 24-hour pad weight < 400 g was an inclusion criterion in the Collado cohort, in which preoperative pad weight predicted outcome[7]

Surgical technique — step by step​

  1. Lithotomy and empty bladder; a catheter may aid urethral identification but is not required by the AdVance XP instructions
  2. Perineal incision 3–4 cm over the bulbar urethra, midway between scrotum and anus
  3. Dissect through bulbospongiosus to expose the bulbar urethra
  4. Mobilize urethra from the central tendon posteriorly. One described technique divides the entire central perineal tendon and marks its distal-most extent, then aligns the proximal edge of the sling body immediately distal to that mark; placing the sling proximal to the landmark has been described as worsening incontinence, though the extent of tendon division needed is debated and no comparative outcome data support one marked position over another.[31]
  5. AdVance XP helical needle passers enter outside-in through small incisions over each obturator foramen toward a finger guarding the urethra in the perineal incision. Do not deploy the needle from perineum toward obturator; the manufacturer explicitly warns against that direction and cautions against vessel perforation, with monitoring for retropubic or periurethral bleeding.[26] Before passage, a spinal finder needle can be placed through the groin-crease stab incision 1.5–2 cm below the adductor longus tendon, directed toward the coccyx at an angle similar to the femur in lithotomy; if it meets bone, small inferomedial adjustments usually find the obturator foramen, and this trajectory then guides the trocar. This is a described planning maneuver, not a manufacturer requirement.[31]
  6. Attach the sling at the perineal needle tip; verify that the blue printing on each sleeve faces away from the corpus spongiosum and that the sling is not twisted, then withdraw each passer along its insertion path to draw the sleeved mesh through the transobturator route.[26]
  7. Mesh positioned retrourethrally behind the bulbar urethra, creating a hammock
  8. Tension the AdVance XP arms evenly until the bulbar urethra moves approximately 2–4 cm proximally; stop before luminal compression or obstruction, as specified in the IFU.[26]
  9. Secure the central mesh to the corpus spongiosum proximally and distally with adequate bites at least two mesh pores from the edge; the AdVance XP instructions recommend resorbable tack sutures, not mandatory non-absorbable fixation
  10. Flexible cystoscopy may confirm coaptation after tensioning. If coaptation is absent, the XP instructions direct loosening and usually repositioning the sling farther distal, removing and replacing tack sutures, and re-tensioning.[26] Assess for injury or obstruction as clinically indicated.
  11. For AdVance XP, remove each plastic sheath by gripping the white liner and sheath without catching the mesh; reassess tension, optionally tunnel the arms subcutaneously, trim them at the level of subcutaneous tissue, then irrigate, achieve hemostasis and close the bulbospongiosus, perineal and obturator incisions.[26] Catheter use and removal depend on the surgeon and postoperative voiding assessment.
  12. Per the AdVance XP instructions, give antibiotic prophylaxis, confirm the patient can empty his bladder, and counsel avoidance of heavy lifting, strenuous exercise and intercourse for at least six weeks.[26] Operative time and discharge vary by patient and center.[8][9]

These steps follow the AdVance XP manufacturer instructions.[26]

Outcomes​

Most AdVance outcome evidence is observational.[8][3] The cure percentages below use different study definitions: Bauer 2009 included one dry security pad, whereas the XP multicenter cohort required zero pads and at most 5 g on a 24-hour pad test.[8][3] Randomized comparisons include the 380-man MASTER sling-versus-AUS trial and a much smaller Argus T-versus-AdVance trial (22 men, 18-month assessment).[15][35]

Short-to-medium term (1–3 yr)​

StudyNFollow-upCureCure + improvedNote
Bauer 2009[8]124 implanted; 70 assessed12 mo36/70 (51.4%; no pad or one dry security pad)54/70 (77.1%)Prospective single-center; rates use the 70 men assessed at 12 mo
Cornu 2009[9]10213 mo (median)62.7%80.4%Prior radiation predicted higher failure (p = 0.039)
Rehder 2012[10]1563 yr—76.8%Stable from 12 mo to 3 yr
Bauer 2017 (XP)[3]115 enrolled; 47 assessed36 mo66.0%89.4%Prospective multicenter; pad weight 272 → 21.8 g; four sling-arm transections for new urgency or elevated PVR (Clavien IIIb), despite no erosions or explantations
Ye 2018 (AdVance; XP not specified)[11]113 implanted24 mo22.6% (no leak and no pad)—75/93 assessed (80.6%) used 0–1 pad/day; reintervention 12.4%; Clavien IIIb 2.7%

Longer term (4+ yr)​

StudyNFollow-upCureCure + improvedNote
Grabbert 2019 (XP)[12]115 enrolled; 60 assessed48 mo71.7%86.7%13.3% failure
Mumm 2021 (XP; same cohort)[42]115 enrolled; 59 assessed60 mo57.6%83.0%25.4% improved; follow-up subset differs from the 48-mo report
Collado 2019[7]9449 mo (median)77%—Preoperative pad weight predicts outcome
Chua 2019[13]21556 mo (mean)96/215 (44.7%; no pads)—Largest long-term series; 150/215 (69.8%) met a composite of no pads or at least 50% improvement plus satisfaction and no further procedure; severity and urgency predicted failure
Papachristos 2018[14]7252 mo (median)51% (pad-free or security pad)76%Australian cohort; 38% dry by pad weight; trend toward declining continence beyond 4 yr

MASTER RCT (sling vs AUS)​

The MASTER trial randomized 380 men with urodynamic stress incontinence after prostate surgery at 27 UK centers to a male transobturator sling (n = 190) or an AUS (n = 190).[15][16]

  • The primary outcome was self-reported incontinence at 12 months (an ICIQ-UI SF composite). The sling was noninferior to the AUS: 87.0% versus 84.2% remained incontinent by this strict definition (134/154 versus 133/158).[15][16] Both papers' risk-difference estimates describe the same 12-month composite comparison, with a lower incontinence rate among AUS recipients. The full report gives an intention-to-treat risk difference of −3.4% (95% CI −11.7 to 4.8; noninferiority p = 0.003)[16]; the 2021 article's Results and Table 2 give −3.6% (95% CI −11.6 to 4.6), while its abstract prints +3.6% with that same confidence interval.[15]
  • The ICIQ-UI SF improved in both groups, with a slightly greater improvement with the AUS (baseline 16.1 and 16.4 to 8.7 and 7.5 at 12 months; adjusted mean difference 1.30, 95% CI 0.11 to 2.49, p = 0.032 in the full report; 1.4, p = 0.02 in the 2021 article).[15][16]
  • Serious adverse events occurred in 8 of 180 sling recipients and 13 of 175 AUS recipients (15 events; one AUS recipient had three) in the full report.[16] The 2021 article reported serious adverse events in six sling recipients and 11 AUS recipients (six and 13 events, respectively).[15]
  • Statistically significant clinical secondary outcomes favored the AUS. Catheter problems affected 45/180 sling recipients (25.0%) versus 13/173 AUS recipients (7.5%; p ≤ 0.001); surgical-site pain was reported on the 12-month questionnaire by 21.7% of 157 sling recipients versus 11.2% of 161 AUS recipients (p = 0.01).[15]
  • The sling was more cost-effective (99% probability at a £30,000 per QALY threshold), with a slightly lower QALY gain.[16]
  • At 24 months the sling remained noninferior (risk difference −0.006, 95% CI −0.092 to 0.080; noninferiority p = 0.001), with ICIQ-UI SF scores of 7.9 (sling) and 7.1 (AUS) from baselines of 16.1 and 16.4 (mean difference 1.42, 95% CI 0.18 to 2.65, p = 0.024). Further surgery was needed in 20 men (11%) after a sling and 4 (2%) after an AUS.[29]

A propensity-score-matched study of 70 men with moderate incontinence (3–5 pads/day) compared the AUS with a retrourethral transobturator sling (TiLOOP Male, not AdVance). The AUS was superior: 94.3% versus 68.6% achieved at least "much improved" on the PGI-I at 12 months without further surgery or explantation (p < 0.001).[17] In a retrospective single-surgeon series, treatment failure (more than 1 pad per day or a further procedure) occurred less often with the AUS than with AdVance/AdVance XP slings in moderate SUI (success 80% versus 63%, p = 0.02).[18] Sling success was 78% in mild SUI.[18]

Key points on durability​

  • In Chua's 215-man series, 44.7% used no pads and 69.8% met study-defined success at a mean 56.4 months; in Papachristos's 72 questionnaire completers, 51% used no pad or a security pad and 76% were cured or improved at a median 52 months.[13][14] The Australian cohort described a trend toward declining continence beyond 4 years.[13][14] Grabbert reported 71.7% cured among 60 assessed men at 48 months in a selected XP cohort; Collado reported 77% cured at a median of 49 months, with five initially cured men showing some deterioration of continence.[12][7] In a prospective ten-year follow-up, 87/111 men completed assessment (median 136.6 months); among 59 cured at three months, 17 later lost continence, including 11 with recurrent SUI, four with de novo urge incontinence and two after salvage radiotherapy.[34]
  • Higher preoperative leakage and prior radiation are consistent negative predictors of fixed-sling success. Collado Serra 2013 reported an OR of 0.996 for cure per 1 g increase in preoperative 24-hour pad weight, equivalent to approximately 0.4% lower odds of cure per gram.[27][13][21]
  • Some cohorts report no erosion or explantation. The manufacturer lists erosion, extrusion, infection and retention among possible adverse events.[3][26]

Complications​

In the prospective Bauer 2010 series (n = 230, median follow-up 17 months) the overall complication rate was 23.9%:[19]

  • Transient acute urinary retention was the main complication (49/230, 21.3%, in this series[19]; 12.9% in the earlier 124-patient series).[8] The AUA guideline states that retention typically resolves within one week.[28]
  • Two slings were explanted (0.9%), one for misplacement and one for symphysitis attributed to Guillain-Barré syndrome.[19]

In a retrospective multicenter review of 127 men (MacAskill 2021), approximately 23% had early postoperative pain. Most cases resolved within 4 weeks, and 2.3% (3 men) had chronic pain (> 3 months) that resolved within 1 year.[20]

Erectile function (IIEF-5) and voiding parameters (IPSS, Qmax, PVR) were not significantly affected in the cited cohorts.[3][8] Seven patients in the Rehder series required a second treatment for SUI (approximately 4.5% of 156), while 14/113 (12.4%) in the Ye series required a second intervention.[10][11] Erosion was uncommon in reports, but remains a listed device risk.[26]

Predictors of failure​

Risk factorEffectStrength of evidence
Prior pelvic radiationOR 0.68 for success across sling types (0.66 in the AdVance subgroup); pooled OR 2.93 for explantation and 3.06 for infectionMeta-analysis of unadjusted odds ratios[21]; small retrospective series[22]
Severe preoperative SUI (≥ 5 PPD)Significantly lower cure / successObservational cohorts[13][14]
Detrusor overactivityAssociated with worse midterm pad use in one AdVance cohort; independent prognostic value across studies remains uncertainRetrospective Habashy cohort (80 men; 10 with DO)[23]; 2024 systematic review[41]
ObesityRR 7.9 for failure after an inside-out transobturator sling[36]Prospective Leruth cohort; Soljanik assessed other AdVance failure predictors[6]
Prior bladder-neck stenosisRR 2.6 for failure after an inside-out transobturator sling[36]Prospective Leruth cohort; Soljanik assessed other AdVance failure predictors[6]
Prior urethral stricture surgeryHigher failure (p = 0.013)Prospective[24]
Weak residual sphincter function with incomplete closureOR 29.0 for failureProspective[6]
No sling tunnelling, or ≤ 4 resorbable fixation stitchesOR 22.6 and OR 8.4 for failureProspective[6]
Prior incontinence surgeryLower continence, improvement, satisfactionMultiple series[25]

Prior radiation is the most consistent negative predictor. In the Ghaffar 2023 meta-analysis across sling types, irradiated patients had an OR of 0.68 for success (95% CI 0.53–0.87); in the AdVance subgroup the OR was 0.66 (95% CI 0.45–0.95).[21] In Torrey 2013 (37 patients, retrospective), none of 7 irradiated men were pad-free versus 63.3% of 30 non-irradiated men.[21][22]

Salvage​

A failed AdVance sling does not preclude subsequent AUS implantation.[25] For persistent or recurrent SUI after a sling, the AUA/GURS/SUFU guideline recommends an AUS .[28] ATOMS has also been reported as a salvage option: in a retrospective multicenter cohort (n = 88, mean follow-up 42.5 months), 67/88 (76.1%) met the study's social-continence definition (no pad or one safety pad with ≤20 mL leakage on a 24-hour pad test) when ATOMS adjustment was complete.[30]

For a carefully selected patient who elects a repeat AdVance after reevaluation and counseling, a described approach starts distally in a less-scarred plane, mobilizes the spongiosum, identifies the old sling's distal edge, and divides its arms to free the urethra before excising the old mesh and closing any spongiosal opening; the repeat sling is then placed slightly distal to the first. Authors describing this technique report entering the spongiosum during mesh removal in about 40% of cases.[32]

Current positioning​

The AdVance XP is used mainly in nonirradiated men with mild-to-moderate PPI and adequate residual sphincter function; a positive repositioning test informs selection alongside other clinical factors.[3][10][18][33] In Zemp's 158-man observational AdVance/XP cohort (mean follow-up 42.7 months), preoperative ≤ 3 PPD was associated with fewer failures than > 3 PPD (13.4% versus 35.5%); 24-hour pad weight < 400 g was an inclusion criterion in Collado's cohort.[40][7] The AUA/GURS/SUFU guideline (2024) says clinicians should discuss male slings for mild-to-moderate SUI after prostate treatment , should not routinely implant them in severe SUI , and should offer an AUS over a sling after radiotherapy .[28] The sling is minimally invasive, works by repositioning rather than obstruction, leaves the AUS option open, and has low reported erosion and explantation rates. Its limitations are lower efficacy than the AUS in moderate SUI, poorer results after radiation, and a possible decline in continence beyond 4 years.

See Also​

Videos​

Step-by-Step Placement of the AdVance XP Male Urethral Sling
AUA University (2023)
Placement of the AdVance XP Male Sling System
Boston Scientific Urology (2019)

References​

1. Welk BK, Herschorn S. The male sling for post-prostatectomy urinary incontinence: a review of contemporary sling designs and outcomes. BJU Int. 2012;109(3):328–344. doi:10.1111/j.1464-410X.2010.10502.x

2. Bauer RM, Kretschmer A, Stief CG, Füllhase C. AdVance and AdVance XP slings for the treatment of post-prostatectomy incontinence. World J Urol. 2015;33(1):145–150. doi:10.1007/s00345-014-1297-2

3. Bauer RM, Grabbert MT, Klehr B, et al. 36-month data for the AdVance XP male sling: results of a prospective multicentre study. BJU Int. 2017;119(4):626–630. doi:10.1111/bju.13704

4. Kahokehr AA, Selph JP, Belsante MJ, et al. Mechanism of action of the transobturator sling for post-radical prostatectomy incontinence: a multi-institutional prospective study using dynamic magnetic resonance imaging. Urology. 2018;116:185–192. doi:10.1016/j.urology.2018.01.053

5. Hüsch T, Kretschmer A, Thomsen F, et al. The AdVance and AdVanceXP male sling in urinary incontinence: is there a difference? World J Urol. 2018;36(10):1657–1662. doi:10.1007/s00345-018-2316-5

6. Soljanik I, Gozzi C, Becker AJ, Stief CG, Bauer RM. Risk factors of treatment failure after retrourethral transobturator male sling. World J Urol. 2012;30(2):201–206. doi:10.1007/s00345-011-0671-6

7. Collado A, Domínguez-Escrig J, Ortiz Rodríguez IM, et al. Functional follow-up after AdVance and AdVance XP male sling surgery: assessment of predictive factors. World J Urol. 2019;37(1):195–200. doi:10.1007/s00345-018-2357-9

8. Bauer RM, Mayer ME, Gratzke C, et al. Prospective evaluation of the functional sling suspension for male postprostatectomy stress urinary incontinence: results after 1 year. Eur Urol. 2009;56(6):928–933. doi:10.1016/j.eururo.2009.07.028

9. Cornu JN, Sèbe P, Ciofu C, et al. The AdVance transobturator male sling for postprostatectomy incontinence: clinical results of a prospective evaluation after a minimum follow-up of 6 months. Eur Urol. 2009;56(6):923–927. doi:10.1016/j.eururo.2009.09.015

10. Rehder P, Haab F, Cornu JN, Gozzi C, Bauer RM. Treatment of postprostatectomy male urinary incontinence with the transobturator retroluminal repositioning sling suspension: 3-year follow-up. Eur Urol. 2012;62(1):140–145. doi:10.1016/j.eururo.2012.02.038

11. Ye H, Haab F, de Ridder D, et al. Effectiveness and complications of the AMS AdVance male sling system for the treatment of stress urinary incontinence: a prospective multicenter study. Urology. 2018;120:197–204. doi:10.1016/j.urology.2018.06.035

12. Grabbert M, Mumm JN, Klehr B, et al. Extended follow-up of the AdVance XP male sling in the treatment of male urinary stress incontinence after 48 months: results of a prospective and multicenter study. Neurourol Urodyn. 2019;38(7):1973–1978. doi:10.1002/nau.24101

13. Chua ME, Zuckerman J, Mason JB, et al. Long-term success durability of transobturator male sling. Urology. 2019;133:222–228. doi:10.1016/j.urology.2019.07.032

14. Papachristos A, Mann S, Talbot K, Moon D. AdVance male urethral sling: medium-term results in an Australian cohort. ANZ J Surg. 2018;88(3):E178–E182. doi:10.1111/ans.13890

15. Abrams P, Constable LD, Cooper D, et al. Outcomes of a noninferiority randomised controlled trial of surgery for men with urodynamic stress incontinence after prostate surgery (MASTER). Eur Urol. 2021;79(6):812–823. doi:10.1016/j.eururo.2021.01.024

16. Constable L, Abrams P, Cooper D, et al. Synthetic sling or artificial urinary sphincter for men with urodynamic stress incontinence after prostate surgery: the MASTER non-inferiority RCT. Health Technol Assess. 2022;26(36):1–152. doi:10.3310/TBFZ0277

17. Sacco E, Gandi C, Marino F, et al. Artificial urinary sphincter significantly better than fixed sling for moderate post-prostatectomy stress urinary incontinence: a propensity score-matched study. BJU Int. 2021;127(2):229–237. doi:10.1111/bju.15197

18. Khouri RK, Ortiz NM, Baumgarten AS, et al. Artificial urinary sphincter outperforms sling for moderate male stress urinary incontinence. Urology. 2020;141:168–172. doi:10.1016/j.urology.2020.03.028

19. Bauer RM, Mayer ME, May F, et al. Complications of the AdVance transobturator male sling in the treatment of male stress urinary incontinence. Urology. 2010;75(6):1494–1498. doi:10.1016/j.urology.2009.12.012

20. MacAskill F, Sheimar K, Toia B, et al. Prevalence of chronic pain following suburethral mesh sling implantation for post-prostatectomy incontinence. Neurourol Urodyn. 2021;40(4):1048–1055. doi:10.1002/nau.24666

21. Ghaffar U, Abbasi B, Fuentes JLG, et al. Urethral slings for irradiated patients with male stress urinary incontinence: a meta-analysis. Urology. 2023;180:262–269. doi:10.1016/j.urology.2023.07.022

22. Torrey R, Rajeshuni N, Ruel N, Muldrew S, Chan K. Radiation history affects continence outcomes after AdVance transobturator sling placement in patients with post-prostatectomy incontinence. Urology. 2013;82(3):713–717. doi:10.1016/j.urology.2013.03.075

23. Habashy D, Losco G, Tse V, Collins R, Chan L. Mid-term outcomes of a male retro-urethral, transobturator synthetic sling for treatment of post-prostatectomy incontinence: impact of radiotherapy and storage dysfunction. Neurourol Urodyn. 2017;36(4):1147–1150. doi:10.1002/nau.23078

24. Cornu JN, Sèbe P, Ciofu C, et al. Mid-term evaluation of the transobturator male sling for post-prostatectomy incontinence: focus on prognostic factors. BJU Int. 2011;108(2):236–240. doi:10.1111/j.1464-410X.2010.09765.x

25. Averbeck MA, Woodhouse C, Comiter C, et al. Surgical treatment of post-prostatectomy stress urinary incontinence in adult men: report from the 6th International Consultation on Incontinence. Neurourol Urodyn. 2019;38(1):398–406. doi:10.1002/nau.23845

26. Boston Scientific. AdVance XP Male Sling System instructions for use, 51117738-01A. English instructions pp. 3–9.

27. Collado Serra A, Resel Folkersma L, Domínguez-Escrig JL, et al. AdVance/AdVance XP transobturator male slings: preoperative degree of incontinence as predictor of surgical outcome. Urology. 2013;81(5):1034–1039. doi:10.1016/j.urology.2013.01.007

28. Breyer BN, Kim SK, Kirkby E, et al. Updates to Incontinence After Prostate Treatment: AUA/GURS/SUFU Guideline (2024). J Urol. 2024;212(4):531–538. doi:10.1097/JU.0000000000004088

29. Constable L, Drake MJ, Cooper D, et al. The 24-mo outcomes from the noninferiority randomised controlled trial of surgery for men with urodynamic stress incontinence after prostate surgery (MASTER). Eur Urol Focus. 2026. doi:10.1016/j.euf.2026.07.012

30. Queissert F, Rourke K, Schönburg S, et al. ATOMS (adjustable transobturator male system) is an effective and safe second-line treatment option for recurrent urinary incontinence after implantation of an AdVance/AdVance XP fixed male sling? A multicenter cohort analysis. J Clin Med. 2022;11(1):81. doi:10.3390/jcm11010081

31. Terlecki RP, Policastro CG, Kovell RC. Male Urethral Sling. In: Smith JA Jr, Dmochowski RR, Thomas JC, Preminger GM, eds. Hinman's Atlas of Urologic Surgery. 5th ed. Elsevier; 2025:799-803.

32. Zuckerman JM, McCammon K. Reconstruction and Salvage of Failed Male Urethral Slings. In: Brandes SB, Morey AF, eds. Advanced Male Urethral and Genital Reconstructive Surgery. 2nd ed. Humana Press; 2014:711-719. doi:10.1007/978-1-4614-7708-2_49

33. Sacco E, Campetella M, Marino F, et al. "Preoperative Risk Factors for Failure After Fixed Sling Implantation for Postprostatectomy Stress Urinary Incontinence (FORESEE): A Systematic Review and Meta-analysis." Eur Urol Open Sci. 2025;77:58–77. doi:10.1016/j.euros.2025.05.012

34. Collado A, Resel L, Romero A, et al. "Long-Term Functional Outcomes and Complications of AdVance/AdVance XP Male Suburethral Slings in the Management of Post-Prostatectomy Incontinence: Multicentric Prospective Ten-Year Follow-Up Study." Neurourol Urodyn. 2026;online ahead of print. doi:10.1002/nau.70341

35. Lima JPC, Pompeo ACL, Bezerra CA. "Argus T versus Advance sling for postprostatectomy urinary incontinence: a randomized clinical trial." Int Braz J Urol. 2016;42(3):531–539. doi:10.1590/S1677-5538.IBJU.2015.0075

36. Leruth J, Waltregny D, de Leval J. "The inside-out transobturator male sling for the surgical treatment of stress urinary incontinence after radical prostatectomy: midterm results of a single-center prospective study." Eur Urol. 2012;61(3):608–615. doi:10.1016/j.eururo.2011.10.036

37. Sandhu JS, Breyer B, Comiter C, et al. "Incontinence After Prostate Treatment: AUA/SUFU Guideline." J Urol. 2019;202(2):369–378. doi:10.1097/JU.0000000000000314

38. Bauer RM, Gozzi C, Roosen A, et al. "Impact of the ‘repositioning test’ on postoperative outcome of retroluminar transobturator male sling implantation." Urol Int. 2013;90(3):334–338. doi:10.1159/000347123

39. Tutolo M, Laenen A, Rosiello G, et al. "Intra/inter-observer reliability of cystoscopic sphincter evaluation in men undergoing sling surgery." BJU Int. 2024;134(1):89–95. doi:10.1111/bju.16353

40. Zemp L, Tong S, Hoy N, Rourke KF. "Preoperative pad usage is independently associated with failure of non-adjustable male trans-obturator slings in otherwise well-selected patients." Can Urol Assoc J. 2019;13(4):120–124. doi:10.5489/cuaj.5468

41. Bhatt NR, et al. "Outcome of post-prostatectomy stress urinary incontinence surgery in men with preoperative idiopathic detrusor overactivity." BJUI Compass. 2024;5(11):1115–1124. doi:10.1002/bco2.442

42. Mumm JN, et al. "Five-Year Results of a Prospective Multicenter Trial: AdVance XP for Postprostatectomy-Incontinence in Patients with Favorable Prognostic Factors." Urol Int. 2021;105(5-6):421–427. doi:10.1159/000512881