OBJECTIVES: The increasing number of prostatectomies entails an increasing 
number of patients suffering from iatrogenic incontinence despite improved 
surgical techniques. The severity of this problem often requires invasive 
treatments such as periurethral injection of bulking agents, artificial urinary 
sphincter (AUS) implantation, and sub-urethral sling positioning. The artificial 
urethral sphincter has represented, until today, the gold standard but, in the 
recent years, sling systems have been investigated as minimally invasive 
alternative options. Today, three different sling procedures are commonly 
performed: bone-anchored, readjustable, and trans-obturator slings systems. The 
aim of this review is to critically report the current status of sling systems 
in the treatment of iatrogenic male incontinence.
MATERIALS AND METHODS: MEDLINE and PubMed databases were searched and all 
articles between 1974 and 2009 were evaluated.
RESULTS: With regard to bone-anchored, readjustable, and trans-obturator slings 
systems, cure rates ranged between 58.0% and 86.0%, 55.5% and 73.0%, and 40.0% 
and 63.0%, respectively, while major complication rates ranged between 0 and 
14.5%, 10.0 and 22.2%, and 0 and 10.0%, respectively.
CONCLUSIONS: Suburethral slings are the only alternative techniques which can be 
favorably compared with the AUS, showing more advantages with respect to AUS 
implantations which are mainly represented by a quick and less invasive 
approach, low morbidity, and low costs. In spite of the difficulty in 
identifying the most effective sling procedure, overall, sling systems can be 
recommended for patients with persistent mild or moderate incontinence. However, 
the indication can also be extended to patients with severe incontinence, after 
appropriate counseling, allowing AUS implantation in the event of sling failure.