Tags

Type your tag names separated by a space and hit enter

Demographic and clinical predictors of treatment failure one year after midurethral sling surgery.
Obstet Gynecol. 2011 Apr; 117(4):913-21.OG

Abstract

OBJECTIVE

To identify clinical and demographic factors predictive of midurethral sling failure.

METHODS

Overall treatment failure was defined by one or more of the following objective outcomes: a positive stress test, positive 24-hour pad test or retreatment for stress urinary incontinence (SUI); subjective outcomes: self reported SUI by the Medical, Epidemiologic and Social Aspect of Aging questionnaire, incontinent episodes by 3-day diary, or retreatment for SUI, or a combination of these. Logistic regression models adjusting for sling type and clinical site were used to predict odds of overall treatment failure after univariable analysis. Models were also fit to compare factors associated with objective failure and subjective failure only.

RESULTS

Previous UI surgery (odds ratio [OR] 1.99, 95% confidence interval [CI] 1.14-3.47); maximum Q-tip excursion<30° (OR 1.89, 95% CI 1.16-3.05); Medical, Epidemiologic and Social Aspect of Aging questionnaire urge score per 10 points (OR 1.97, 95% CI 1.21-3.21); and pad weight per 10 g (OR 1.06, 95% CI 1.02-1.10) were predictors of overall failure. Having concomitant surgery (OR 0.44, 95% CI 0.22-0.90) was predictive of subjective failure only rather than objective failure. Age per 10 years (OR 1.48, 95% CI 1.14-1.90); Urogenital Distress Inventory score per 10 points (OR 1.09, 95% CI 1.02-1.17); pad weight per 10 g (OR 1.05, 95% CI 1.01-1.10) were predictive of objective failure compared with subjective failure only. Associations of risk factors and failure were similar independent of sling type (retropubic or transobturator).

CONCLUSION

Twelve months after surgery, risk factors for overall and objective treatment failure were similar in women undergoing retropubic and transobturator sling procedures. This information may assist in counseling patients regarding efficacy of sling procedures and in setting expectations for women at increased odds for treatment failure.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, www.clinicaltrials.gov, NCT00325039.

LEVEL OF EVIDENCE

II.

Authors+Show Affiliations

University of Alabama at Birmingham, Birmingham, Alabama, USA. hrichter@uab.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

21422865

Citation

Richter, Holly E., et al. "Demographic and Clinical Predictors of Treatment Failure One Year After Midurethral Sling Surgery." Obstetrics and Gynecology, vol. 117, no. 4, 2011, pp. 913-21.
Richter HE, Litman HJ, Lukacz ES, et al. Demographic and clinical predictors of treatment failure one year after midurethral sling surgery. Obstet Gynecol. 2011;117(4):913-21.
Richter, H. E., Litman, H. J., Lukacz, E. S., Sirls, L. T., Rickey, L., Norton, P., Lemack, G. E., Kraus, S., Moalli, P., Fitzgerald, M. P., Dandreo, K. J., Huang, L., & Kusek, J. W. (2011). Demographic and clinical predictors of treatment failure one year after midurethral sling surgery. Obstetrics and Gynecology, 117(4), 913-21. https://doi.org/10.1097/AOG.0b013e31820f3892
Richter HE, et al. Demographic and Clinical Predictors of Treatment Failure One Year After Midurethral Sling Surgery. Obstet Gynecol. 2011;117(4):913-21. PubMed PMID: 21422865.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Demographic and clinical predictors of treatment failure one year after midurethral sling surgery. AU - Richter,Holly E, AU - Litman,Heather J, AU - Lukacz,Emily S, AU - Sirls,Larry T, AU - Rickey,Leslie, AU - Norton,Peggy, AU - Lemack,Gary E, AU - Kraus,Stephen, AU - Moalli,Pamela, AU - Fitzgerald,Mary Pat, AU - Dandreo,Kimberly J, AU - Huang,Liyuan, AU - Kusek,John W, AU - ,, PY - 2011/3/23/entrez PY - 2011/3/23/pubmed PY - 2012/6/8/medline SP - 913 EP - 21 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 117 IS - 4 N2 - OBJECTIVE: To identify clinical and demographic factors predictive of midurethral sling failure. METHODS: Overall treatment failure was defined by one or more of the following objective outcomes: a positive stress test, positive 24-hour pad test or retreatment for stress urinary incontinence (SUI); subjective outcomes: self reported SUI by the Medical, Epidemiologic and Social Aspect of Aging questionnaire, incontinent episodes by 3-day diary, or retreatment for SUI, or a combination of these. Logistic regression models adjusting for sling type and clinical site were used to predict odds of overall treatment failure after univariable analysis. Models were also fit to compare factors associated with objective failure and subjective failure only. RESULTS: Previous UI surgery (odds ratio [OR] 1.99, 95% confidence interval [CI] 1.14-3.47); maximum Q-tip excursion<30° (OR 1.89, 95% CI 1.16-3.05); Medical, Epidemiologic and Social Aspect of Aging questionnaire urge score per 10 points (OR 1.97, 95% CI 1.21-3.21); and pad weight per 10 g (OR 1.06, 95% CI 1.02-1.10) were predictors of overall failure. Having concomitant surgery (OR 0.44, 95% CI 0.22-0.90) was predictive of subjective failure only rather than objective failure. Age per 10 years (OR 1.48, 95% CI 1.14-1.90); Urogenital Distress Inventory score per 10 points (OR 1.09, 95% CI 1.02-1.17); pad weight per 10 g (OR 1.05, 95% CI 1.01-1.10) were predictive of objective failure compared with subjective failure only. Associations of risk factors and failure were similar independent of sling type (retropubic or transobturator). CONCLUSION: Twelve months after surgery, risk factors for overall and objective treatment failure were similar in women undergoing retropubic and transobturator sling procedures. This information may assist in counseling patients regarding efficacy of sling procedures and in setting expectations for women at increased odds for treatment failure. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00325039. LEVEL OF EVIDENCE: II. SN - 1873-233X UR - https://www.unboundmedicine.com/medline/citation/21422865/Demographic_and_clinical_predictors_of_treatment_failure_one_year_after_midurethral_sling_surgery_ L2 - http://dx.doi.org/10.1097/AOG.0b013e31820f3892 DB - PRIME DP - Unbound Medicine ER -