To evaluate the safety and efficacy of transtobturator urethral sling operation in the treatment of male stress urinary incontinence.

A retrospective analysis was conducted on the clinical data of 13 male patients with stress urinary incontinence who underwent transvaginal sling procedure at Peking University People's Hospital from June 2011 to July 2024. The patients' average age was 71.6±5.4 years. Among them, 9 patients had undergone radical prostatectomy, and 4 had undergone transurethral resection of the prostate (TURP). Of the 13 patients, 7 had moderate urinary incontinence, and 6 had severe urinary incontinence. The daily number of urine pads used by the 13 patients before surgery was 5, and the score on the Incontinence Quality of Life Questionnaire (I-QOL) was 16. The score on the Male Stress Urinary Incontinence Grading System (MSIGS) was 2. All 13 patients underwent transvaginal sling procedure. The patients were placed in the lithotomy position, and the urethral bulb was dissected anatomically beneath the scrotum. The sling was guided by a needle and pulled out through the obturator foramen, and placed over the urethral bulb. The sling was tightened and the tension adjusted to fully suspend the urethra. A urinary catheter was left in place for 1-7 days after surgery. The patients' postoperative daily use of urine pads, scores of the I-QOL and MSIGS, and postoperative complications were followed up.

Postoperative follow-up ranged from 2 to 139 months, with a median follow-up time of 12 months. Of the 13 patients, 2 were cured, 9 had improved and 2 had no significant improvement. The number of diapers used per day by patients postoperatively was 1 (1,4); the I-QOL score was 75 (46,82), and the MSIGS score was 1 (0,2), which were significantly improved compared to preoperative values (P < 0.01). Among the 6 severe stress urinary incontinence patients who were followed up, the number of diapers used per day was significantly reduced compared to preoperative values[ 2(1~5)  vs. 8(7~8) pieces], and the I-QOL score was significantly improved [ 60(35~70) vs. 12(10~16) points], while the MSIGS score was significantly lower [ 2(1~3)  vs. 3(2~4) points].

Among the 7 moderate stress urinary incontinence patients, the number of diapers used per day was significantly reduced compared to preoperative values [1 (0~1) vs. 4 (4~5) pieces], and the I-QOL score was significantly improved [ 80(75,82) vs. 21(18,30) points], while the MSIGS score was significantly lower [ 0 (0~1) vs. 2 (2~3) points]. The symptoms of 1 patient were not significantly improved after the surgery, and were improved after Virtue sling suspension 3 years later.

The efficacy of transtobturator urethral sling operation treating male stress urinary incontinence is accurate, and the incidence of postoperative complications is low.