OBJECTIVES: To evaluate retrospectively the objective and subjective parameters 
in 42 male patients who underwent bone anchored sub-urethral sling positioning 
(BAUS) for SUI (stress urinary incontinence) due to ISD (intrinsic sphincter 
deficiency).
METHODS: Patients with SUI due to radical retropubic prostatectomy (36 
patients), transurethral resection of prostate (5 patients) and open simple 
prostatectomy (1 patient) underwent BAUS positioning between July 1999 and 
September 2005 (mean FU = 41 months). Before and after surgery, the patients 
were evaluated by physical examination, urethrocystoscopy, urodynamics, 1 h pad 
test and QoL questionnaire. Surgical technique involved perineal implantation to 
the pubic rami using four anchors of a sub-urethral sling made of synthetic (26 
patients), biological (4 patients) or mixed (12 patients) material. Patients 
were stratified into three groups: (1) Cured: dry patients at stress test, pad 
weight 0-1 g. (2) Improved: patients with mild-moderate incontinence, pad weight 
2-50 g. (3) Failed: unchanged patients, pad weight > 50 g.
RESULTS: At the final follow-up visit cured, improved and failed patients were 
26 (62%), 4 (8%) and 12 (30%), respectively. Mean pad weight significantly 
decreased from 104.6 to 47.3 g (55%) and mean total questionnaire score 
significantly increased to 50.7 (66%). Mean ALPP significantly increased to 50.4 
cmH2O (44.8%). Better results were seen with synthetic slings. Main 
complications were perineal pain (76%), detrusor overactivity (12%) and sling 
infection (4.8%).
CONCLUSIONS: BAUS implantation is a safe, effective, minimally invasive option 
for iatrogenic male incontinence due to ISD. It compares favourably with AUS.