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Comparison of retropubic synthetic mid-urethral slings to fascia pubovaginal slings following failed sling surgery.
Neurourol Urodyn. 2016 09; 35(7):851-4.NU

Abstract

AIMS

Mid-urethral slings are considered first-line surgical treatment of stress urinary incontinence. However, there is a paucity of data regarding the use of mid-urethral slings (MUS) for patients who have failed a prior sling procedure.

MATERIALS AND METHODS

After receiving IRB approval, a multi-institutional retrospective review of 224 consecutive patients undergoing placement of a retropubic MUS (n = 153) or autologous rectus fascia (ARF) pubovaginal sling (n = 71) for prior failed sling surgery is conducted. Pre- and post-operative pad use is recorded for all patients in addition to completion of four validated questionnaires pre- and post-operatively: SEAPI-QMM incontinence classification system (stress-related leak, emptying ability, anatomy, protection, inhibition, quality of life, mobility, and mental status), incontinence impact questionnaire (IIQ-7), urogenital distress inventory (UDI-6), and 10-point visual analog score (VAS).

RESULTS

Median follow-up is 29 months and the overall subjective cure rate was 61.4%. A statistically significant improvement in pad use and in all validated questionnaire outcomes is observed for secondary repair with a retropubic sling. In further sub-analysis between the MUS and the ARF groups, there are no significant differences in subjective cure rates or changes in post-operative questionnaire outcomes.

CONCLUSIONS

Secondary repair with a retropubic sling is a durable and effective procedure for patients who have failed prior sling procedures without differences in outcomes noted between retropubic MUS and ARF slings. Neurourol. Urodynam. 35:851-854, 2016. © 2015 Wiley Periodicals, Inc.

Authors+Show Affiliations

Department of Urology, The University of Kansas Medical Center, Kansas City, Kansas.Department of Urology, Louisiana State University Health, Shreveport, Louisiana.Department of Urology, The University of Kansas Medical Center, Kansas City, Kansas.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26175333

Citation

Aberger, Michael, et al. "Comparison of Retropubic Synthetic Mid-urethral Slings to Fascia Pubovaginal Slings Following Failed Sling Surgery." Neurourology and Urodynamics, vol. 35, no. 7, 2016, pp. 851-4.
Aberger M, Gomelsky A, Padmanabhan P. Comparison of retropubic synthetic mid-urethral slings to fascia pubovaginal slings following failed sling surgery. Neurourol Urodyn. 2016;35(7):851-4.
Aberger, M., Gomelsky, A., & Padmanabhan, P. (2016). Comparison of retropubic synthetic mid-urethral slings to fascia pubovaginal slings following failed sling surgery. Neurourology and Urodynamics, 35(7), 851-4. https://doi.org/10.1002/nau.22819
Aberger M, Gomelsky A, Padmanabhan P. Comparison of Retropubic Synthetic Mid-urethral Slings to Fascia Pubovaginal Slings Following Failed Sling Surgery. Neurourol Urodyn. 2016;35(7):851-4. PubMed PMID: 26175333.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of retropubic synthetic mid-urethral slings to fascia pubovaginal slings following failed sling surgery. AU - Aberger,Michael, AU - Gomelsky,Alexander, AU - Padmanabhan,Priya, Y1 - 2015/07/14/ PY - 2015/04/05/received PY - 2015/06/08/accepted PY - 2015/7/16/entrez PY - 2015/7/16/pubmed PY - 2017/12/22/medline KW - midurethral slings KW - reoperation KW - stress urinary incontinence KW - surgical mesh SP - 851 EP - 4 JF - Neurourology and urodynamics JO - Neurourol Urodyn VL - 35 IS - 7 N2 - AIMS: Mid-urethral slings are considered first-line surgical treatment of stress urinary incontinence. However, there is a paucity of data regarding the use of mid-urethral slings (MUS) for patients who have failed a prior sling procedure. MATERIALS AND METHODS: After receiving IRB approval, a multi-institutional retrospective review of 224 consecutive patients undergoing placement of a retropubic MUS (n = 153) or autologous rectus fascia (ARF) pubovaginal sling (n = 71) for prior failed sling surgery is conducted. Pre- and post-operative pad use is recorded for all patients in addition to completion of four validated questionnaires pre- and post-operatively: SEAPI-QMM incontinence classification system (stress-related leak, emptying ability, anatomy, protection, inhibition, quality of life, mobility, and mental status), incontinence impact questionnaire (IIQ-7), urogenital distress inventory (UDI-6), and 10-point visual analog score (VAS). RESULTS: Median follow-up is 29 months and the overall subjective cure rate was 61.4%. A statistically significant improvement in pad use and in all validated questionnaire outcomes is observed for secondary repair with a retropubic sling. In further sub-analysis between the MUS and the ARF groups, there are no significant differences in subjective cure rates or changes in post-operative questionnaire outcomes. CONCLUSIONS: Secondary repair with a retropubic sling is a durable and effective procedure for patients who have failed prior sling procedures without differences in outcomes noted between retropubic MUS and ARF slings. Neurourol. Urodynam. 35:851-854, 2016. © 2015 Wiley Periodicals, Inc. SN - 1520-6777 UR - https://www.unboundmedicine.com/medline/citation/26175333/Comparison_of_retropubic_synthetic_mid_urethral_slings_to_fascia_pubovaginal_slings_following_failed_sling_surgery_ DB - PRIME DP - Unbound Medicine ER -