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Management of recurrent stress urinary incontinence after failed midurethral sling: tape tightening or repeat sling?
Int Urogynecol J. 2012 Sep; 23(9):1279-84.IU

Abstract

INTRODUCTION AND HYPOTHESIS

This study was performed to compare surgical outcomes of repeat midurethral sling (MUS) with those of tape shortening in patients who underwent failed initial MUS.

METHODS

We assessed 66 patients who underwent failed initial MUS and a second surgical procedure because of recurrent or persistent stress urinary incontinence (SUI), including 36 who underwent repeat MUS and 30 who underwent tape shortening. All patients were followed up for at least 12 months after second surgery. Efficacy was measured by cure rates on the Sandvik questionnaire. Safety was evaluated by assessing maximal urine flow rate, postvoid residual urine volume, and procedure-related complications.

RESULTS

The cure rate was significantly higher in patients who underwent repeat MUS (72.2 % vs. 46.7 %, p = 0.034). Among patients with a Valsalva leak point pressure (VLPP) of <60 cmH(2)O or SUI severity of at least moderate, the cure rate was significantly higher in those who underwent repeat MUS than in those who underwent tape shortening (76.5 % vs. 40.0 % and 79.2 % vs. 43.8 %, respectively). Univariate analysis of preoperative factors demonstrated that there were no risk factors associated with the cure rates in either group. One patient who underwent repeat MUS required tape cutting, and one who underwent tape shortening experienced mesh erosion. A limitation of this study is that it was not a randomized, controlled study.

CONCLUSIONS

Repeat MUS has a higher cure rate than does tape shortening in surgical treatment of patient with persistent or recurrent SUI, especially those with low VLPP or high SUI grade.

Authors+Show Affiliations

Department of Urology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan, 626-770 Gyeongnam, Korea.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22527541

Citation

Han, Ji-Yeon, et al. "Management of Recurrent Stress Urinary Incontinence After Failed Midurethral Sling: Tape Tightening or Repeat Sling?" International Urogynecology Journal, vol. 23, no. 9, 2012, pp. 1279-84.
Han JY, Moon KH, Park CM, et al. Management of recurrent stress urinary incontinence after failed midurethral sling: tape tightening or repeat sling? Int Urogynecol J. 2012;23(9):1279-84.
Han, J. Y., Moon, K. H., Park, C. M., & Choo, M. S. (2012). Management of recurrent stress urinary incontinence after failed midurethral sling: tape tightening or repeat sling? International Urogynecology Journal, 23(9), 1279-84. https://doi.org/10.1007/s00192-012-1737-8
Han JY, et al. Management of Recurrent Stress Urinary Incontinence After Failed Midurethral Sling: Tape Tightening or Repeat Sling. Int Urogynecol J. 2012;23(9):1279-84. PubMed PMID: 22527541.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of recurrent stress urinary incontinence after failed midurethral sling: tape tightening or repeat sling? AU - Han,Ji-Yeon, AU - Moon,Kyung Hyun, AU - Park,Chang Myeon, AU - Choo,Myung-Soo, Y1 - 2012/04/14/ PY - 2011/10/09/received PY - 2012/03/04/accepted PY - 2012/4/25/entrez PY - 2012/4/25/pubmed PY - 2013/2/27/medline SP - 1279 EP - 84 JF - International urogynecology journal JO - Int Urogynecol J VL - 23 IS - 9 N2 - INTRODUCTION AND HYPOTHESIS: This study was performed to compare surgical outcomes of repeat midurethral sling (MUS) with those of tape shortening in patients who underwent failed initial MUS. METHODS: We assessed 66 patients who underwent failed initial MUS and a second surgical procedure because of recurrent or persistent stress urinary incontinence (SUI), including 36 who underwent repeat MUS and 30 who underwent tape shortening. All patients were followed up for at least 12 months after second surgery. Efficacy was measured by cure rates on the Sandvik questionnaire. Safety was evaluated by assessing maximal urine flow rate, postvoid residual urine volume, and procedure-related complications. RESULTS: The cure rate was significantly higher in patients who underwent repeat MUS (72.2 % vs. 46.7 %, p = 0.034). Among patients with a Valsalva leak point pressure (VLPP) of <60 cmH(2)O or SUI severity of at least moderate, the cure rate was significantly higher in those who underwent repeat MUS than in those who underwent tape shortening (76.5 % vs. 40.0 % and 79.2 % vs. 43.8 %, respectively). Univariate analysis of preoperative factors demonstrated that there were no risk factors associated with the cure rates in either group. One patient who underwent repeat MUS required tape cutting, and one who underwent tape shortening experienced mesh erosion. A limitation of this study is that it was not a randomized, controlled study. CONCLUSIONS: Repeat MUS has a higher cure rate than does tape shortening in surgical treatment of patient with persistent or recurrent SUI, especially those with low VLPP or high SUI grade. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/22527541/Management_of_recurrent_stress_urinary_incontinence_after_failed_midurethral_sling:_tape_tightening_or_repeat_sling L2 - https://dx.doi.org/10.1007/s00192-012-1737-8 DB - PRIME DP - Unbound Medicine ER -