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The Risk of Recurrent Urinary Incontinence Requiring Surgery After Suburethral Sling Removal for Mesh Complications.
Urology. 2017 08; 106:203-209.U

Abstract

OBJECTIVE

We sought to examine the risk of recurrent stress urinary incontinence (SUI) after suburethral sling mesh removal or excision.

MATERIALS AND METHODS

We conducted a retrospective cohort study of patients who were continent before removal or excision of synthetic midurethral slings; this cohort of 278 subjects was much larger than seen in previous such studies. Patients with preoperative incontinence, additional vaginal mesh placements, prior mesh revision/excision, existing SUI, and prior pelvic radiation or fistula were excluded. Only patients with follow-up detailing continence status within 1 year of mesh removal were examined.

RESULTS

Of 278 patients, 117 (70 retropubic and 47 transobturator) midurethral sling removals met inclusion criteria. Demographic data were comparable between groups. Presenting symptoms were also similar, with similar extrusion rates. Chronic pain was the reason for mesh removal in 80% of cases. In 1 year of follow-up, 38.6% (27/70) retropubic and 34.0% (16/47) transobturator sling removals had SUI requiring an anti-incontinence procedure. Total sling mesh removal was performed in 51.4% of retropubic vaginal mesh and 51.1% of transobturator mesh cases.

CONCLUSION

In this continent population with sling complications, approximately 1/3 developed significant SUI within 1 year of mesh removal requiring anti-incontinence surgery, regardless of the amount or type of mesh removed. Total mesh removal did not increase SUI risk.

Authors+Show Affiliations

Division of Urology, Department of Surgery, Siriraj Hospital, Mahidol University, Thailand.Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA. Electronic address: a.lenore.ackerman@cshs.org.Division of Urology and Urologic Oncology, Department of Surgery, City of Hope, Duarte, CA.Division of Urology and Urologic Oncology, Department of Surgery, City of Hope, Duarte, CA.Division of Urology and Urologic Oncology, Department of Surgery, City of Hope, Duarte, CA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28476681

Citation

Ramart, Patkawat, et al. "The Risk of Recurrent Urinary Incontinence Requiring Surgery After Suburethral Sling Removal for Mesh Complications." Urology, vol. 106, 2017, pp. 203-209.
Ramart P, Ackerman AL, Cohen SA, et al. The Risk of Recurrent Urinary Incontinence Requiring Surgery After Suburethral Sling Removal for Mesh Complications. Urology. 2017;106:203-209.
Ramart, P., Ackerman, A. L., Cohen, S. A., Kim, J. H., & Raz, S. (2017). The Risk of Recurrent Urinary Incontinence Requiring Surgery After Suburethral Sling Removal for Mesh Complications. Urology, 106, 203-209. https://doi.org/10.1016/j.urology.2017.01.060
Ramart P, et al. The Risk of Recurrent Urinary Incontinence Requiring Surgery After Suburethral Sling Removal for Mesh Complications. Urology. 2017;106:203-209. PubMed PMID: 28476681.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Risk of Recurrent Urinary Incontinence Requiring Surgery After Suburethral Sling Removal for Mesh Complications. AU - Ramart,Patkawat, AU - Ackerman,A Lenore, AU - Cohen,Seth A, AU - Kim,Ja-Hong, AU - Raz,Shlomo, Y1 - 2017/05/02/ PY - 2016/11/10/received PY - 2017/01/23/revised PY - 2017/01/27/accepted PY - 2017/5/10/pubmed PY - 2018/11/27/medline PY - 2017/5/7/entrez SP - 203 EP - 209 JF - Urology JO - Urology VL - 106 N2 - OBJECTIVE: We sought to examine the risk of recurrent stress urinary incontinence (SUI) after suburethral sling mesh removal or excision. MATERIALS AND METHODS: We conducted a retrospective cohort study of patients who were continent before removal or excision of synthetic midurethral slings; this cohort of 278 subjects was much larger than seen in previous such studies. Patients with preoperative incontinence, additional vaginal mesh placements, prior mesh revision/excision, existing SUI, and prior pelvic radiation or fistula were excluded. Only patients with follow-up detailing continence status within 1 year of mesh removal were examined. RESULTS: Of 278 patients, 117 (70 retropubic and 47 transobturator) midurethral sling removals met inclusion criteria. Demographic data were comparable between groups. Presenting symptoms were also similar, with similar extrusion rates. Chronic pain was the reason for mesh removal in 80% of cases. In 1 year of follow-up, 38.6% (27/70) retropubic and 34.0% (16/47) transobturator sling removals had SUI requiring an anti-incontinence procedure. Total sling mesh removal was performed in 51.4% of retropubic vaginal mesh and 51.1% of transobturator mesh cases. CONCLUSION: In this continent population with sling complications, approximately 1/3 developed significant SUI within 1 year of mesh removal requiring anti-incontinence surgery, regardless of the amount or type of mesh removed. Total mesh removal did not increase SUI risk. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/28476681/The_Risk_of_Recurrent_Urinary_Incontinence_Requiring_Surgery_After_Suburethral_Sling_Removal_for_Mesh_Complications_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(17)30407-7 DB - PRIME DP - Unbound Medicine ER -