Tags

Type your tag names separated by a space and hit enter

Characterization of Lower Urinary Tract Symptoms Before and After Midurethral Sling Revision.
J Minim Invasive Gynecol. 2016 Sep-Oct; 23(6):979-85.JM

Abstract

STUDY OBJECTIVE

To characterize outcomes in women undergoing surgical revision of a midurethral sling and characterize factors associated with satisfaction of revision.

DESIGN

Retrospective cohort study (Canadian Task Force classification II-3).

SETTING

A urogynecology clinic at a large academic referral center.

PATIENTS

Women undergoing surgical revision of synthetic mesh midurethral sling (index surgery).

INTERVENTIONS

Chart review was performed to obtain baseline clinicodemographic information, operative notes, urodynamic parameters, and symptom-specific distress and impact questionnaire data. Eligible women were then sent follow-up questionnaires that assessed reasons for index surgery, presence of dyspareunia, symptom-specific distress and impact, and satisfaction after mesh midurethral sling surgery.

MEASUREMENTS AND MAIN RESULTS

Of 144 eligible women, 69 (47.9%) responded, 15 (10.4%) declined participation or were deceased, and 59 (41.6%) did not respond. The mean time from index surgery was 22.2 ± 14.0 months. Women with transobturator slings were more frequently revised for vaginal exposure (p = .003), whereas women with retropubic slings were more frequently revised for voiding dysfunction (p < .0001). Sixty-four percent of women were satisfied with surgery. Satisfied women had more improvement in pain (p = .04), dyspareunia (p < .001), and Patient Global Impression of Improvement questionnaire scores (p < .0001). Multivariable analysis showed that satisfaction decreased with increasing years in age (adjusted odds ratio = 0.95; 95% confidence interval, 0.90-0.99).

CONCLUSION

Women who were satisfied with sling revision were younger and more likely to have resolution of pain and dyspareunia and improved Patient Global Impression of Improvement scores. This information may help to inform patients regarding expectations with regard to sling revision.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address: aparden@uabmc.edu.Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama.Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27393288

Citation

Parden, Alison M., et al. "Characterization of Lower Urinary Tract Symptoms Before and After Midurethral Sling Revision." Journal of Minimally Invasive Gynecology, vol. 23, no. 6, 2016, pp. 979-85.
Parden AM, Tang Y, Szychowski J, et al. Characterization of Lower Urinary Tract Symptoms Before and After Midurethral Sling Revision. J Minim Invasive Gynecol. 2016;23(6):979-85.
Parden, A. M., Tang, Y., Szychowski, J., & Richter, H. E. (2016). Characterization of Lower Urinary Tract Symptoms Before and After Midurethral Sling Revision. Journal of Minimally Invasive Gynecology, 23(6), 979-85. https://doi.org/10.1016/j.jmig.2016.06.015
Parden AM, et al. Characterization of Lower Urinary Tract Symptoms Before and After Midurethral Sling Revision. J Minim Invasive Gynecol. 2016 Sep-Oct;23(6):979-85. PubMed PMID: 27393288.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterization of Lower Urinary Tract Symptoms Before and After Midurethral Sling Revision. AU - Parden,Alison M, AU - Tang,Ying, AU - Szychowski,Jeff, AU - Richter,Holly E, Y1 - 2016/07/05/ PY - 2016/04/13/received PY - 2016/06/22/revised PY - 2016/06/23/accepted PY - 2016/7/10/entrez PY - 2016/7/10/pubmed PY - 2017/7/14/medline KW - Complications KW - Midurethral sling KW - Revision SP - 979 EP - 85 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 23 IS - 6 N2 - STUDY OBJECTIVE: To characterize outcomes in women undergoing surgical revision of a midurethral sling and characterize factors associated with satisfaction of revision. DESIGN: Retrospective cohort study (Canadian Task Force classification II-3). SETTING: A urogynecology clinic at a large academic referral center. PATIENTS: Women undergoing surgical revision of synthetic mesh midurethral sling (index surgery). INTERVENTIONS: Chart review was performed to obtain baseline clinicodemographic information, operative notes, urodynamic parameters, and symptom-specific distress and impact questionnaire data. Eligible women were then sent follow-up questionnaires that assessed reasons for index surgery, presence of dyspareunia, symptom-specific distress and impact, and satisfaction after mesh midurethral sling surgery. MEASUREMENTS AND MAIN RESULTS: Of 144 eligible women, 69 (47.9%) responded, 15 (10.4%) declined participation or were deceased, and 59 (41.6%) did not respond. The mean time from index surgery was 22.2 ± 14.0 months. Women with transobturator slings were more frequently revised for vaginal exposure (p = .003), whereas women with retropubic slings were more frequently revised for voiding dysfunction (p < .0001). Sixty-four percent of women were satisfied with surgery. Satisfied women had more improvement in pain (p = .04), dyspareunia (p < .001), and Patient Global Impression of Improvement questionnaire scores (p < .0001). Multivariable analysis showed that satisfaction decreased with increasing years in age (adjusted odds ratio = 0.95; 95% confidence interval, 0.90-0.99). CONCLUSION: Women who were satisfied with sling revision were younger and more likely to have resolution of pain and dyspareunia and improved Patient Global Impression of Improvement scores. This information may help to inform patients regarding expectations with regard to sling revision. SN - 1553-4669 UR - https://www.unboundmedicine.com/medline/citation/27393288/Characterization_of_Lower_Urinary_Tract_Symptoms_Before_and_After_Midurethral_Sling_Revision_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1553-4650(16)30137-6 DB - PRIME DP - Unbound Medicine ER -