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Risk factors for stress urinary incontinence recurrence after single‐incision sling
Author(s) -
Palmieri Stefania,
Frigerio Matteo,
Spelzini Federico,
Manodoro Stefano,
Milani Rodolfo
Publication year - 2018
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.23487
Subject(s) - medicine , urology , overactive bladder , urinary incontinence , univariate analysis , concomitant , sling (weapon) , risk factor , multivariate analysis , surgery , alternative medicine , pathology
Aims The aim of the study was to identify in a pure stress urinary incontinence (SUI) population risk factors for recurrence after single‐incision slings (SIS). Methods This retrospective study analyzed women with complaints of SUI symptoms and urodynamically proven SUI. Exclusion criteria were recurrent SUI, overactive bladder syndrome/detrusor overactivity, preoperative postvoid residual >100 mL, reduced urethral mobility (<10° at the Q‐tip test), concomitant anterior prolapse >I stage and previous history of radical pelvic surgery. Objective cure rate was assessed with stress test. Results A total of 192 patients were analyzed. Objective cure rate was obtained in 86.5% of patients. According to univariate analysis, recurrences had higher prevalence of severe ICIQ‐SF score (≥18 points), higher prevalence of reduced urethral mobility (Qtip ≤30°), higher prevalence of low detrusor pressures during voiding phase (opening pressure <15 cmH 2 O, pressure at maximum flow <20 cmH 2 O, closing pressure <15 cmH 2 O), and higher prevalence of postoperative complications According to multivariate analysis ICIQ‐SF score ≥18 points ( P = 0.02; OR = 2.7) and detrusor pressure at maximum flow <20 cmH 2 O ( P < 0.01; OR = 3.6) resulted as independent risk factors for SUI recurrence (Table 3). A trend was found for urethral mobility ≤30° ( P = 0.07; OR = 2.2). Conclusions Our study identifies SUI severity expressed with ICIQ‐SF scores and low detrusor pressure at maximum flow as independent risk factors for SUI recurrence after SIS implantation while only a trend was found for reduced urethral mobility. Therefore, preoperative assessment of symptoms and urodynamics evaluation may play a key role in improving preoperative counseling and tailoring surgical treatment.