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Salvage autologous fascial sling after failed synthetic midurethral sling: Greater than 3-year outcomes.
Int J Urol. 2016 02; 23(2):178-81.IJ

Abstract

OBJECTIVE

To determine long-term surgical outcomes of salvage autologous fascial sling placement after a failed synthetic midurethral sling.

METHODS

Women who had undergone autologous fascial sling placement without concomitant pelvic surgery for a failed synthetic midurethral sling utilizing mesh with a minimum follow up of 36 months were identified. Charts were reviewed, and patients were contacted by telephone. Success was determined by the Patient Global Impression of Improvement. Secondary measures included the Incontinence Severity Index questionnaire, patient recommendation of the autologous fascial sling and need for further incontinence surgery.

RESULTS

A total of 35 patients met the criteria, and 21 were successfully contacted. Of those contacted, the median age at surgery was 67 years (range 53-81 years) and at the time of the survey was 75 years (range 63-84 years) with median follow up of 74 months (range 36-127 years). Preoperatively, 12 patients (57.1%) had urethral hypermobility and 13 patients (61.9%) had mixed urinary incontinence. Eight patients (38.1%) had concomitant sling excision with five of those combined with urethrolysis at the time of the salvage operation. Patient Global Impression of Improvement success was noted in 16 patients (76.2%). A total of 11 patients (52.4%) were dry or had slight incontinence by the Incontinence Severity Index. One patient required additional anti-incontinence surgery (4.8%). A total of 18 patients (85.7%) recommended the autologous fascial sling. No statistical impact was noted with sling excision (P = 0.62), mixed urinary incontinence (P = 0.61), age at surgery (P = 0.23), age at follow up (P = 0.15), length of follow up (P = 0.71) or first surgery type (transobturator tape vs retropubic; P = 1.00).

CONCLUSIONS

Autologous fascial sling provides reasonable long-term success as a salvage operation for failed midurethral slings.

Authors+Show Affiliations

Department of Urology, Mayo Clinic, Jacksonville, Florida, USA.Department of Urology, Mayo Clinic, Jacksonville, Florida, USA.Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, Florida, USA. Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.Department of Health Sciences Research, Mayo Clinic, Jacksonville, Florida, USA.Department of Urology, Mayo Clinic, Jacksonville, Florida, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26563492

Citation

Petrou, Steven P., et al. "Salvage Autologous Fascial Sling After Failed Synthetic Midurethral Sling: Greater Than 3-year Outcomes." International Journal of Urology : Official Journal of the Japanese Urological Association, vol. 23, no. 2, 2016, pp. 178-81.
Petrou SP, Davidiuk AJ, Rawal B, et al. Salvage autologous fascial sling after failed synthetic midurethral sling: Greater than 3-year outcomes. Int J Urol. 2016;23(2):178-81.
Petrou, S. P., Davidiuk, A. J., Rawal, B., Arnold, M., & Thiel, D. D. (2016). Salvage autologous fascial sling after failed synthetic midurethral sling: Greater than 3-year outcomes. International Journal of Urology : Official Journal of the Japanese Urological Association, 23(2), 178-81. https://doi.org/10.1111/iju.13003
Petrou SP, et al. Salvage Autologous Fascial Sling After Failed Synthetic Midurethral Sling: Greater Than 3-year Outcomes. Int J Urol. 2016;23(2):178-81. PubMed PMID: 26563492.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Salvage autologous fascial sling after failed synthetic midurethral sling: Greater than 3-year outcomes. AU - Petrou,Steven P, AU - Davidiuk,Andrew J, AU - Rawal,Bhupendra, AU - Arnold,Michelle, AU - Thiel,David D, Y1 - 2015/11/13/ PY - 2015/04/28/received PY - 2015/10/04/accepted PY - 2015/11/14/entrez PY - 2015/11/14/pubmed PY - 2018/7/31/medline KW - autologous fascial sling KW - failed midurethral sling KW - recurrent stress urinary incontinence KW - repeat sling KW - salvage fascial sling SP - 178 EP - 81 JF - International journal of urology : official journal of the Japanese Urological Association JO - Int J Urol VL - 23 IS - 2 N2 - OBJECTIVE: To determine long-term surgical outcomes of salvage autologous fascial sling placement after a failed synthetic midurethral sling. METHODS: Women who had undergone autologous fascial sling placement without concomitant pelvic surgery for a failed synthetic midurethral sling utilizing mesh with a minimum follow up of 36 months were identified. Charts were reviewed, and patients were contacted by telephone. Success was determined by the Patient Global Impression of Improvement. Secondary measures included the Incontinence Severity Index questionnaire, patient recommendation of the autologous fascial sling and need for further incontinence surgery. RESULTS: A total of 35 patients met the criteria, and 21 were successfully contacted. Of those contacted, the median age at surgery was 67 years (range 53-81 years) and at the time of the survey was 75 years (range 63-84 years) with median follow up of 74 months (range 36-127 years). Preoperatively, 12 patients (57.1%) had urethral hypermobility and 13 patients (61.9%) had mixed urinary incontinence. Eight patients (38.1%) had concomitant sling excision with five of those combined with urethrolysis at the time of the salvage operation. Patient Global Impression of Improvement success was noted in 16 patients (76.2%). A total of 11 patients (52.4%) were dry or had slight incontinence by the Incontinence Severity Index. One patient required additional anti-incontinence surgery (4.8%). A total of 18 patients (85.7%) recommended the autologous fascial sling. No statistical impact was noted with sling excision (P = 0.62), mixed urinary incontinence (P = 0.61), age at surgery (P = 0.23), age at follow up (P = 0.15), length of follow up (P = 0.71) or first surgery type (transobturator tape vs retropubic; P = 1.00). CONCLUSIONS: Autologous fascial sling provides reasonable long-term success as a salvage operation for failed midurethral slings. SN - 1442-2042 UR - https://www.unboundmedicine.com/medline/citation/26563492/Salvage_autologous_fascial_sling_after_failed_synthetic_midurethral_sling:_Greater_than_3_year_outcomes_ L2 - https://doi.org/10.1111/iju.13003 DB - PRIME DP - Unbound Medicine ER -