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Surgical outcome of a repeat midurethral sling procedure after failure of a first procedure.
Int Urogynecol J. 2015 Dec; 26(12):1759-66.IU

Abstract

INTRODUCTION AND HYPOTHESIS

Although there is no consensus on the management of persistent or recurrent stress urinary incontinence (SUI) after placement of a midurethral synthetic sling (MUS), a repeat MUS procedure is commonly performed with favorable results. The aim of this study was to evaluate the efficacy of a repeat MUS procedure compared to the primary procedure in women with SUI, and to investigate factors associated with the failure of the repeat procedure.

METHODS

We retrospectively analyzed data from 53 women who underwent a repeat MUS procedure and 102 women who underwent a primary MUS procedure at a single center. Success was defined as no urine leakage during physical activity based on the Sandvik questionnaire. Outcomes were assessed using the Sandvik Severity Index and Incontinence-Quality of Life (I-QOL) questionnaire. Multivariate logistic regression analysis was used to determine the factors predicting failure of the repeat procedure.

RESULTS

The success rate was 76.5 % for the primary MUS procedure (78/102 patients) and 69.8 % for the repeat MUS procedure (37/53 patients; p = 0.369). The mean follow-up duration was significantly longer for the primary procedure (83.8 months vs. 54.6 months, p < 0.001). SUI and all domain scores of the I-QOL were significantly better following the repeat MUS procedure than following the primary procedure. In the multivariate analysis, SUI grade 3 was the only independent factor predicting failure of the repeat qq (odds ratio 7.610, p = 0.023).

CONCLUSIONS

A repeat MUS procedure after a failed primary MUS procedure was shown to be effective. However, a repeat procedure may be unsuccessful in patients with grade 3 SUI.

Authors+Show Affiliations

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 135-710, Republic of Korea.Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 135-710, Republic of Korea.Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 135-710, Republic of Korea. ksleedr@skku.edu. Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Korea. ksleedr@skku.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26174657

Citation

Kim, Tae Heon, et al. "Surgical Outcome of a Repeat Midurethral Sling Procedure After Failure of a First Procedure." International Urogynecology Journal, vol. 26, no. 12, 2015, pp. 1759-66.
Kim TH, You HW, Ryu DS, et al. Surgical outcome of a repeat midurethral sling procedure after failure of a first procedure. Int Urogynecol J. 2015;26(12):1759-66.
Kim, T. H., You, H. W., Ryu, D. S., & Lee, K. S. (2015). Surgical outcome of a repeat midurethral sling procedure after failure of a first procedure. International Urogynecology Journal, 26(12), 1759-66. https://doi.org/10.1007/s00192-015-2773-y
Kim TH, et al. Surgical Outcome of a Repeat Midurethral Sling Procedure After Failure of a First Procedure. Int Urogynecol J. 2015;26(12):1759-66. PubMed PMID: 26174657.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical outcome of a repeat midurethral sling procedure after failure of a first procedure. AU - Kim,Tae Heon, AU - You,Hyun Wook, AU - Ryu,Dong-Soo, AU - Lee,Kyu-Sung, Y1 - 2015/07/15/ PY - 2015/04/11/received PY - 2015/06/22/accepted PY - 2015/7/16/entrez PY - 2015/7/16/pubmed PY - 2016/10/13/medline KW - Prostheses and implants KW - Reoperation KW - Stress KW - Urinary incontinence SP - 1759 EP - 66 JF - International urogynecology journal JO - Int Urogynecol J VL - 26 IS - 12 N2 - INTRODUCTION AND HYPOTHESIS: Although there is no consensus on the management of persistent or recurrent stress urinary incontinence (SUI) after placement of a midurethral synthetic sling (MUS), a repeat MUS procedure is commonly performed with favorable results. The aim of this study was to evaluate the efficacy of a repeat MUS procedure compared to the primary procedure in women with SUI, and to investigate factors associated with the failure of the repeat procedure. METHODS: We retrospectively analyzed data from 53 women who underwent a repeat MUS procedure and 102 women who underwent a primary MUS procedure at a single center. Success was defined as no urine leakage during physical activity based on the Sandvik questionnaire. Outcomes were assessed using the Sandvik Severity Index and Incontinence-Quality of Life (I-QOL) questionnaire. Multivariate logistic regression analysis was used to determine the factors predicting failure of the repeat procedure. RESULTS: The success rate was 76.5 % for the primary MUS procedure (78/102 patients) and 69.8 % for the repeat MUS procedure (37/53 patients; p = 0.369). The mean follow-up duration was significantly longer for the primary procedure (83.8 months vs. 54.6 months, p < 0.001). SUI and all domain scores of the I-QOL were significantly better following the repeat MUS procedure than following the primary procedure. In the multivariate analysis, SUI grade 3 was the only independent factor predicting failure of the repeat qq (odds ratio 7.610, p = 0.023). CONCLUSIONS: A repeat MUS procedure after a failed primary MUS procedure was shown to be effective. However, a repeat procedure may be unsuccessful in patients with grade 3 SUI. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/26174657/Surgical_outcome_of_a_repeat_midurethral_sling_procedure_after_failure_of_a_first_procedure_ L2 - https://dx.doi.org/10.1007/s00192-015-2773-y DB - PRIME DP - Unbound Medicine ER -