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Repeat synthetic mid urethral sling procedure for women with recurrent stress urinary incontinence.J Urol. 2010 Jan; 183(1):241-6.JU
Abstract
PURPOSE
We reported and compared the outcomes of repeat mid urethral sling with primary mid urethral sling in women with stress urinary incontinence.
MATERIALS AND METHODS
A total of 1,225 consecutive women with urodynamic stress incontinence underwent a synthetic mid urethral sling procedure (955 retropubic, 270 transobturator) at our institution between 1999 and 2007. Of the patients 91% (1,112) were interviewed via telephone call with a structured questionnaire and were included in the analysis. Mean +/- SD followup was 50 +/- 24 months (range 12 to 114). A comparison between repeat (77, mean age 62 +/- 12 years) and primary (1,035, mean age 60 +/- 13 years) mid urethral sling groups was performed. Repeat sling was placed without removal of the previous sling.
RESULTS
The preoperative incidence of intrinsic sphincter deficiency was higher in patients who had a repeat mid urethral sling (31% vs 13%, p <0.001). The subjective stress incontinence cure rate was 86% and 62% in the primary and repeat group, respectively (p <0.001). The repeat retropubic approach was significantly more successful than the repeat transobturator approach (71% vs 48%, p = 0.04). The rates of sling related and general postoperative complications were similar between the primary and the repeat groups. However, de novo urgency (30% vs 14%, p <0.001) and de novo urge urinary incontinence (22% vs 5%, p <0.001) were more frequent in the repeat group compared with the primary group.
CONCLUSIONS
A repeat synthetic mid urethral sling procedure has a significantly lower cure rate than a primary mid urethral sling procedure. The repeat retropubic approach has a higher success rate than the repeat transobturator approach. The incidence of de novo urgency and urge incontinence are significantly higher in repeat procedures.
Links
MeSH
Pub Type(s)
Comparative Study
Journal Article
Language
eng
PubMed ID
19913831
Citation
Stav, Kobi, et al. "Repeat Synthetic Mid Urethral Sling Procedure for Women With Recurrent Stress Urinary Incontinence." The Journal of Urology, vol. 183, no. 1, 2010, pp. 241-6.
Stav K, Dwyer PL, Rosamilia A, et al. Repeat synthetic mid urethral sling procedure for women with recurrent stress urinary incontinence. J Urol. 2010;183(1):241-6.
Stav, K., Dwyer, P. L., Rosamilia, A., Schierlitz, L., Lim, Y. N., Chao, F., De Souza, A., Thomas, E., Murray, C., Conway, C., & Lee, J. (2010). Repeat synthetic mid urethral sling procedure for women with recurrent stress urinary incontinence. The Journal of Urology, 183(1), 241-6. https://doi.org/10.1016/j.juro.2009.08.111
Stav K, et al. Repeat Synthetic Mid Urethral Sling Procedure for Women With Recurrent Stress Urinary Incontinence. J Urol. 2010;183(1):241-6. PubMed PMID: 19913831.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - Repeat synthetic mid urethral sling procedure for women with recurrent stress urinary incontinence.
AU - Stav,Kobi,
AU - Dwyer,Peter L,
AU - Rosamilia,Anna,
AU - Schierlitz,Lore,
AU - Lim,Yik N,
AU - Chao,Fay,
AU - De Souza,Alison,
AU - Thomas,Elizabeth,
AU - Murray,Christine,
AU - Conway,Christine,
AU - Lee,Joseph,
PY - 2009/03/25/received
PY - 2009/11/17/entrez
PY - 2009/11/17/pubmed
PY - 2010/1/7/medline
SP - 241
EP - 6
JF - The Journal of urology
JO - J Urol
VL - 183
IS - 1
N2 - PURPOSE: We reported and compared the outcomes of repeat mid urethral sling with primary mid urethral sling in women with stress urinary incontinence. MATERIALS AND METHODS: A total of 1,225 consecutive women with urodynamic stress incontinence underwent a synthetic mid urethral sling procedure (955 retropubic, 270 transobturator) at our institution between 1999 and 2007. Of the patients 91% (1,112) were interviewed via telephone call with a structured questionnaire and were included in the analysis. Mean +/- SD followup was 50 +/- 24 months (range 12 to 114). A comparison between repeat (77, mean age 62 +/- 12 years) and primary (1,035, mean age 60 +/- 13 years) mid urethral sling groups was performed. Repeat sling was placed without removal of the previous sling. RESULTS: The preoperative incidence of intrinsic sphincter deficiency was higher in patients who had a repeat mid urethral sling (31% vs 13%, p <0.001). The subjective stress incontinence cure rate was 86% and 62% in the primary and repeat group, respectively (p <0.001). The repeat retropubic approach was significantly more successful than the repeat transobturator approach (71% vs 48%, p = 0.04). The rates of sling related and general postoperative complications were similar between the primary and the repeat groups. However, de novo urgency (30% vs 14%, p <0.001) and de novo urge urinary incontinence (22% vs 5%, p <0.001) were more frequent in the repeat group compared with the primary group. CONCLUSIONS: A repeat synthetic mid urethral sling procedure has a significantly lower cure rate than a primary mid urethral sling procedure. The repeat retropubic approach has a higher success rate than the repeat transobturator approach. The incidence of de novo urgency and urge incontinence are significantly higher in repeat procedures.
SN - 1527-3792
UR - https://www.unboundmedicine.com/medline/citation/19913831/Repeat_synthetic_mid_urethral_sling_procedure_for_women_with_recurrent_stress_urinary_incontinence_
L2 - https://www.jurology.com/doi/10.1016/j.juro.2009.08.111?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed
DB - PRIME
DP - Unbound Medicine
ER -
