Infla10® Pulse™Also Known As
Adjustable male sling, Male Re-adjustable System (MRS), adjustable suburethral sling, readjustable suburethral male sling, adjustable transobturator male sling, adjustable continence therapy for men
Definition
A readjustable male sling is a surgical implant device designed to treat male stress urinary incontinence (SUI), particularly following radical prostatectomy.1 It consists of a synthetic mesh or silicone pad positioned beneath the bulbar urethra to provide compression and urethral coaptation, with a mechanism that allows for postoperative tension adjustment to optimize continence outcomes.2 The device works by creating direct compression of the bulbourethral urethra in a hammock-like effect, resulting in urethral luminal coaptation while allowing for tension readjustment after implantation to address persistent or recurrent incontinence.3 The primary purpose of this device is to restore continence while maintaining the patient’s ability to void spontaneously, offering a less invasive alternative to artificial urinary sphincter implantation.4
Clinical Context
The readjustable male sling is primarily used in the clinical management of stress urinary incontinence (SUI) in men following radical prostatectomy, where external urethral sphincter function may be compromised.1 Patient selection criteria typically include men with mild to moderate SUI (using 0-5 pads per day or with a 24-hour pad weight of less than 500 grams), who have not responded adequately to conservative management such as pelvic floor muscle training and medical therapy.2 The device is particularly suitable for patients with some degree of residual voluntary sphincter function, as determined through urodynamic studies and cystoscopy.3
The surgical implantation procedure can be performed via transobturator or retropubic approaches, depending on the specific device design.4 The transobturator approach involves creating a perineal incision to expose the bulbar urethra, followed by passing the sling arms through the obturator foramen to position the sling beneath the urethra.3 The retropubic approach requires both perineal and abdominal incisions, with the sling arms passed from the perineum to the suprapubic area.3
Expected outcomes include significant reduction in daily pad usage and improved quality of life, with success rates ranging from 60-70% in most studies.1,5 The adjustability feature allows for postoperative tension modification to optimize continence outcomes without requiring complete device removal or replacement.2 Recovery typically involves 4-6 weeks of restricted physical activity, with patients able to void spontaneously after catheter removal.4 While radiation history is not an absolute contraindication, it may be associated with lower success rates.5