Urinary Incontinence (NUI) due to sphincter deficiency in males is one of the most challenging conditions for the urologists. The main complaint is urinary leakage between clean intermittent catheterism (CIC). The most common treatment is hydraulic artificial sphincter placed around the bladder neck which represents a major and difficult surgical procedure. The use of a tansobturatory sling could resent a simpler and safer procedure to restore continence and thus quality of life in this specific population.

After Ethics Committee Approval and an informed consent signature10 male patients ageing from 21 to 60 (mean= 39, 2 years) suffering from NUI due to sphincter deficiency underwent Argus T® Sling implantation. Etiology of neurogenic bladder was myelomeningocele in 7 and spinal cord injury in three. All of the patients had a good bladder capacity obtained with medication in two, botulin toxin injection in three and bladder augmentation in five (50%). All of them had a preserved upper urinary tract and 8 (80%) perform CIC. Maximum cytometric capacity ranged from 300 – 500 ml (mean= 410, 5 ml) and Valsalva Leak Point pressure varied from 28 to 133 cmH2O (mean= 81, 1 vmH2O). Preoperative pad count varied from 1 – 7 pads/day (mean= 4,2 pads/day). All patients evaluated their quality of life as poor. Mean pre-operative ICS SF was 15
All patients underwent surgical implantation of the Argus T® under general anesthesia. We adjust sling tension until reaching a pressure of 40 cm H2O. A Foley catheter was left overnight. In the first post operative day CIC was reintroduced and patient discharged. 
Follow up included early and late complications as well as patient satisfaction. A Clavien Dindo Scale was used to classify surgical complications. 
Results were based on reduction of daily pad counts, Improvement in quality of life and patient satisfaction. We have used the T of Student test for paired values to compare pre and post operative parameters.

Follow up was possible in 9 of 10 patients. Follow up ranged from two to 18 months (mean= 9,6). Nine patients remain with the sling. Two patients (22%) have erosion of the Sling columns requiring surgical debridement. 
Eight patients (88%) have significant improvement in urinary leakage and are satisfied with the procedure. Overall pad count reduced from four, 2 to 1, 2 (p<0,05). 
Currently, eight out of nine patients are satisfied with their new continence status. All nine patients continue to do CIC without difficulties. 
We did not have any major Clavien Dindo surgical complications. \Two patients reported sling collum erosion and were treated by surgical debridement.

Transobturatory Argus Sling (Argus T) represents an effective and safe treatment for NUI. The procedure has a success close to 80% and is accompanied by an acceptable index of complications even in patients with bladder augmentation. 
A larger number of patients and longer follow up remains necessary to confirm these results.

Argus T can be considered an alternative for patients with NUI and a good reservoir function. 

Consider ARGUS T as an alternative to artificial sphincter in males with NUI due to sphincter deficiency