PurposeTo determine mid-term durability of the AdVance sling for post-prostatectomy incontinence (PPI) and impact of prior radiotherapy and storage dysfunction. MethodEighty men undergoing AdVance sling for PPI during 2008-2013 were reviewed. Pre-op urodynamics, pre and post-op pad usage, prior radiotherapy, and PGI-I scores were recorded. ResultMean follow-up was 36 months (range 14-72). Twelve men had radiotherapy pre-op, 10 had detrusor overactivity (DO), and 20 reduced compliance. Pre-op mean 24-hr pad weight was 264g and mean pads-per-day (PPD) 2.600.29. In the early post-op period (3-6 months), mean PPD was 0.40 (SD 0.16); at mid-term follow-up mean PPD was 1.02 +/- 0.31. Radiotherapy and DO were independently predictive of poor mid-term outcome. Men with DO or radiotherapy were using 1.03 +/- 0.42 (P=0.019) and 1.17 +/- 0.41 (P=0.02) more PPD, respectively than men without these factors. At mid-term follow-up, men without radiotherapy or DO were using 1.98 +/- 0.28 less PPD compared to pre-operatively (P<0.0001); with radiotherapy or DO men were using 0.73 +/- 0.38 (P=0.057) and 0.72 +/- 0.43 (P=0.092) less PPD, respectively. PGI-I score for men without radiotherapy or DO was 1.98 +/- 0.40 (much better); with radiotherapy or DO PGI-I score was 3.80 +/- 0.49 (no difference). ConclusionThe AdVance sling provides mid-term improvement in men with PPI. However, men with radiotherapy or DO have significantly poorer outcomes with mid-term results indicating a return to baseline degree of incontinence. Caution should be taken when considering the AdVance sling in these men. Pre-op urodynamics in men with radiotherapy and/or overactive bladder may be important when considering men for AdVance sling. Neurourol. Urodynam. 36:1147-1150, 2017. (c) 2016 Wiley Periodicals, Inc.