Premium
Long‐term outcomes of transobturator midurethral slings: A critical evaluation of a real‐world population
Author(s) -
Valadez Librado,
Frilot Clifton F.,
Gomelsky Alex
Publication year - 2020
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.24518
Subject(s) - medicine , sling (weapon) , urinary incontinence , concomitant , perioperative , retrospective cohort study , cohort , institutional review board , quality of life (healthcare) , genitourinary system , surgery , cohort study , population , environmental health , nursing
Aims The American Urological Association/Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction stress urinary incontinence (SUI) guidelines strongly recommend the midurethral sling (MUS) for the index female patient with SUI. While numerous studies report long‐term outcomes and complications for the retropubic MUS, these are largely absent for the transobturator MUS and are assessed in this study. Methods This is an Institutional Review Board approved retrospective chart review of all women who underwent a transobturator MUS at a single institution from 2004 to 2010. Pre‐ and postoperative assessment included a cough–stress test, SEAPI assessment, and validated quality‐of‐life (QoL) questionnaires. SUI resolution was defined as no subjective or objective SUI, and no additional surgery to achieve stress continence. Results Of 437 women, 305 (70%) had a minimum follow‐up of 48 months (mean 88; median 92). SUI was resolved in 69% of the entire cohort and 58% of the 78 women who had MUS only. The median time to SUI recurrence was 38 months in the entire cohort and 18 months in the MUS only group. Perioperative complications were infrequent and typically associated with concomitant surgery. A statistically significant improvement was observed in SEAPI scores and all QoL indices postoperatively. Conclusions Long‐term resolution of SUI after the transobturator MUS is achieved by 69%, which is commensurate with success rates reported in the literature. Overall, women experience a significant improvement in their QoL after transobturator MUS; however, late recurrences and delayed sequelae may occur. Thus, long‐term follow‐up is warranted in this population.