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Autologous pubovaginal sling for recurrent stress urinary incontinence after two or more failed synthetic midurethral sling.
Eur J Obstet Gynecol Reprod Biol. 2022 May; 272:213-216.EJ

Abstract

OBJECTIVE

To determine efficacy and safety of salvage autologous pubovaginal sling (PVS) placement after a two or more failed synthetic midurethral sling.

METHODS

Women undergoing autologous PVS placement for two or more failed synthetic MUS between 2008 and 2019 were identified. Those patients were conducted a follow-up examination. Outcomes of surgery were assessed using the cough stress test with a full bladder and symptom questionnaire, including Incontinence Visual Analogue Scale (I-VAS) and Incontinence Quality of Life (I-QOL) questionnaire. Surgical results were categorized into three classes: cured, improved, and failed. Secondary measures included patients' recommendation of autologous fascial sling (AFS).

RESULTS

A total of 18 eligible patients met the criteria, of whom median age at surgery was 67 (52-74) years with a median follow-up of 80 (12-144) months. Preoperatively, all patients were identified by urodynamic test with Valsalva leak point pressure (VLPP) < 60 cmH2O. All patients had concomitant part sling excision combined with urethrolysis at the salvage operation. At the follow-up examination, sixteen in eighteen (88.89%) patients were cured and improved. The postoperative total score and each individual domain in I-QOL improved significantly compared with the baseline (p < 0.001). Postoperative I-VAS was significantly lower than preoperative (1.3 ± 0.6 vs. 7.8 ± 2.2, p < 0.001). A total of 16 patients (88.89%) recommended the AFS to others. Neither perioperative blood transfusions nor other complications above Clavien level 3 were observed.

CONCLUSIONS

Our study indicates that autologous PVS is effective and safe in women with recurrent stress urinary incontinence after two or more failed synthetic MUS.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Chen J
Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Department of Urology, Institute of Urology, West China Hospital, Sichuan University, PR China.
Li B
Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Department of Urology, Institute of Urology, West China Hospital, Sichuan University, PR China.
Peng L
Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Department of Urology, Institute of Urology, West China Hospital, Sichuan University, PR China.
Shen H
Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Department of Urology, Institute of Urology, West China Hospital, Sichuan University, PR China.
Luo D
Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Department of Urology, Institute of Urology, West China Hospital, Sichuan University, PR China. Electronic address: luodeyi1985@163.com.

MeSH

FemaleHumansMaleQuality of LifeRetrospective StudiesSuburethral SlingsUrinary IncontinenceUrinary Incontinence, StressUrologic Surgical Procedures

Pub Type(s)

Journal Article

Language

eng

PubMed ID

35381543

Citation

Chen, Jiawei, et al. "Autologous Pubovaginal Sling for Recurrent Stress Urinary Incontinence After Two or More Failed Synthetic Midurethral Sling." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 272, 2022, pp. 213-216.
Chen J, Li B, Peng L, et al. Autologous pubovaginal sling for recurrent stress urinary incontinence after two or more failed synthetic midurethral sling. Eur J Obstet Gynecol Reprod Biol. 2022;272:213-216.
Chen, J., Li, B., Peng, L., Shen, H., & Luo, D. (2022). Autologous pubovaginal sling for recurrent stress urinary incontinence after two or more failed synthetic midurethral sling. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 272, 213-216. https://doi.org/10.1016/j.ejogrb.2022.03.024
Chen J, et al. Autologous Pubovaginal Sling for Recurrent Stress Urinary Incontinence After Two or More Failed Synthetic Midurethral Sling. Eur J Obstet Gynecol Reprod Biol. 2022;272:213-216. PubMed PMID: 35381543.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Autologous pubovaginal sling for recurrent stress urinary incontinence after two or more failed synthetic midurethral sling. AU - Chen,Jiawei, AU - Li,Boya, AU - Peng,Liao, AU - Shen,Hong, AU - Luo,Deyi, Y1 - 2022/03/31/ PY - 2021/11/01/received PY - 2022/01/19/revised PY - 2022/03/11/accepted PY - 2022/4/6/pubmed PY - 2022/5/18/medline PY - 2022/4/5/entrez KW - Autologous pubovaginal sling KW - Recurrent stress urinary incontinence KW - Synthetic midurethral sling SP - 213 EP - 216 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur J Obstet Gynecol Reprod Biol VL - 272 N2 - OBJECTIVE: To determine efficacy and safety of salvage autologous pubovaginal sling (PVS) placement after a two or more failed synthetic midurethral sling. METHODS: Women undergoing autologous PVS placement for two or more failed synthetic MUS between 2008 and 2019 were identified. Those patients were conducted a follow-up examination. Outcomes of surgery were assessed using the cough stress test with a full bladder and symptom questionnaire, including Incontinence Visual Analogue Scale (I-VAS) and Incontinence Quality of Life (I-QOL) questionnaire. Surgical results were categorized into three classes: cured, improved, and failed. Secondary measures included patients' recommendation of autologous fascial sling (AFS). RESULTS: A total of 18 eligible patients met the criteria, of whom median age at surgery was 67 (52-74) years with a median follow-up of 80 (12-144) months. Preoperatively, all patients were identified by urodynamic test with Valsalva leak point pressure (VLPP) < 60 cmH2O. All patients had concomitant part sling excision combined with urethrolysis at the salvage operation. At the follow-up examination, sixteen in eighteen (88.89%) patients were cured and improved. The postoperative total score and each individual domain in I-QOL improved significantly compared with the baseline (p < 0.001). Postoperative I-VAS was significantly lower than preoperative (1.3 ± 0.6 vs. 7.8 ± 2.2, p < 0.001). A total of 16 patients (88.89%) recommended the AFS to others. Neither perioperative blood transfusions nor other complications above Clavien level 3 were observed. CONCLUSIONS: Our study indicates that autologous PVS is effective and safe in women with recurrent stress urinary incontinence after two or more failed synthetic MUS. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/35381543/Autologous_pubovaginal_sling_for_recurrent_stress_urinary_incontinence_after_two_or_more_failed_synthetic_midurethral_sling_ DB - PRIME DP - Unbound Medicine ER -