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[Can candidates for reimplantation of suburethral sling after sling removal due to chronic obstruction be identified intraoperatively?].
Prog Urol. 2008 Apr; 18(4):238-44.PU

Abstract

OBJECTIVE

To intraoperatively identify candidates for immediate reimplantation of a suburethral sling after sling removal due to chronic obstruction.

MATERIAL AND METHOD

Clinical study of 22 women, operated by suburethral sling for stress urinary incontinence between 2000 and 2007, who subsequently developed lower urinary tract obstructive symptoms. The suburethral sling was removed in all patients under local anaesthesia and fentanyl/midazolam sedation. Immediate replacement of the suburethral sling was performed in patients with cough incontinence demonstrated intraoperatively after sling removal. The measure of handicap urinary (MHU) questionnaire, UDI-6/IIQ-7 score and uroflowmetry with determination of the post-voiding residual volume were performed before and three months after the operation.

RESULT

Twelve patients (group 1) underwent removal and reimplantation of a new sling and 10 patients (group 2) underwent simple sling removal. The two groups were comparable. In each group, a significant difference was observed between preoperative and postoperative post-voiding residual volume, peak flow rate and MHU score and a non-significant difference was observed for the UDI-6/IIQ-7 score in group 2, in contrast to group 1. The urinary continence rate was 100% in both groups. The success rate, defined urodynamically, was 75% in group 1 and 80% in group 2. The success rate, defined by resolution of the initial urinary symptoms and improvement of the questionnaire score, was 75% in group 1 and 90% in group 2.

CONCLUSION

Candidates for immediate replacement of suburethral sling after sling removal due to obstructive symptoms can be identified intraoperatively. The cough test under local anaesthesia and fentanyl/midazolam sedation allows selection of these patients. Immediate sling replacement is accompanied by good results on continence without inducing a new obstruction.

Authors+Show Affiliations

Service d'urologie, hôpital Civil, hôpitaux universitaires de Strasbourg, 1, place de l'hôpital, 67000 Strasbourg, France.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

fre

PubMed ID

18501304

Citation

Mouracade, P, et al. "[Can Candidates for Reimplantation of Suburethral Sling After Sling Removal Due to Chronic Obstruction Be Identified Intraoperatively?]." Progres En Urologie : Journal De l'Association Francaise D'urologie Et De La Societe Francaise D'urologie, vol. 18, no. 4, 2008, pp. 238-44.
Mouracade P, Lang H, Jacqmin D, et al. [Can candidates for reimplantation of suburethral sling after sling removal due to chronic obstruction be identified intraoperatively?]. Prog Urol. 2008;18(4):238-44.
Mouracade, P., Lang, H., Jacqmin, D., & Saussine, C. (2008). [Can candidates for reimplantation of suburethral sling after sling removal due to chronic obstruction be identified intraoperatively?]. Progres En Urologie : Journal De l'Association Francaise D'urologie Et De La Societe Francaise D'urologie, 18(4), 238-44. https://doi.org/10.1016/j.purol.2008.03.003
Mouracade P, et al. [Can Candidates for Reimplantation of Suburethral Sling After Sling Removal Due to Chronic Obstruction Be Identified Intraoperatively?]. Prog Urol. 2008;18(4):238-44. PubMed PMID: 18501304.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Can candidates for reimplantation of suburethral sling after sling removal due to chronic obstruction be identified intraoperatively?]. AU - Mouracade,P, AU - Lang,H, AU - Jacqmin,D, AU - Saussine,C, Y1 - 2008/04/28/ PY - 2007/05/04/received PY - 2008/03/05/accepted PY - 2008/5/27/pubmed PY - 2008/11/1/medline PY - 2008/5/27/entrez SP - 238 EP - 44 JF - Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie JO - Prog Urol VL - 18 IS - 4 N2 - OBJECTIVE: To intraoperatively identify candidates for immediate reimplantation of a suburethral sling after sling removal due to chronic obstruction. MATERIAL AND METHOD: Clinical study of 22 women, operated by suburethral sling for stress urinary incontinence between 2000 and 2007, who subsequently developed lower urinary tract obstructive symptoms. The suburethral sling was removed in all patients under local anaesthesia and fentanyl/midazolam sedation. Immediate replacement of the suburethral sling was performed in patients with cough incontinence demonstrated intraoperatively after sling removal. The measure of handicap urinary (MHU) questionnaire, UDI-6/IIQ-7 score and uroflowmetry with determination of the post-voiding residual volume were performed before and three months after the operation. RESULT: Twelve patients (group 1) underwent removal and reimplantation of a new sling and 10 patients (group 2) underwent simple sling removal. The two groups were comparable. In each group, a significant difference was observed between preoperative and postoperative post-voiding residual volume, peak flow rate and MHU score and a non-significant difference was observed for the UDI-6/IIQ-7 score in group 2, in contrast to group 1. The urinary continence rate was 100% in both groups. The success rate, defined urodynamically, was 75% in group 1 and 80% in group 2. The success rate, defined by resolution of the initial urinary symptoms and improvement of the questionnaire score, was 75% in group 1 and 90% in group 2. CONCLUSION: Candidates for immediate replacement of suburethral sling after sling removal due to obstructive symptoms can be identified intraoperatively. The cough test under local anaesthesia and fentanyl/midazolam sedation allows selection of these patients. Immediate sling replacement is accompanied by good results on continence without inducing a new obstruction. SN - 1166-7087 UR - https://www.unboundmedicine.com/medline/citation/18501304/[Can_candidates_for_reimplantation_of_suburethral_sling_after_sling_removal_due_to_chronic_obstruction_be_identified_intraoperatively]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1166-7087(08)00080-8 DB - PRIME DP - Unbound Medicine ER -