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Comparison of retropubic synthetic mid‐urethral slings to fascia pubovaginal slings following failed sling surgery
Author(s) -
Aberger Michael,
Gomelsky Alexander,
Padmanabhan Priya
Publication year - 2016
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22819
Subject(s) - medicine , sling (weapon) , urinary incontinence , surgery , urinary retention , genitourinary system , urology
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.