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Does the suburethral sling change its location?
Author(s) -
Majkusiak Wojciech,
Pomian Andrzej,
Tomasik Paweł,
Horosz Edyta,
Zwierzchowska Aneta,
Kociszewski Jacek,
Barcz Ewa
Publication year - 2017
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13448
Subject(s) - sling (weapon) , medicine , overweight , surgery , cohort , prospective cohort study , urinary incontinence , urology , obesity
Objectives To ascertain whether a phenomenon of sling migration exists after suburethral sling placement, whether this might be responsible for suboptimal sling location and persistent incontinence, and whether a link exists between sling dislocation or migration and risk factors, such as obesity or age. Methods The present prospective cohort study was carried out in a group of 244 patients who underwent retropubic sling implantation. Sling location was determined by means of pelvic floor ultrasound, and calculated relative to the individual patient's urethral length measured before the procedure. The sling location was visualized on 1 day, and 1 and 6 months post‐surgery. Overweight/obese and elderly patients were analyzed separately to assess the possible influence of those factors on sling location. Results The mean urethral length in the studied cohort was 28.76 ± 3.67 mm. The mean tape position 1 day post‐surgery was 66.18 ± 8.43% of the urethral length, and it did not change 1 and 6 months post‐surgery in the whole group. Similar results were obtained in elderly and overweight/obese patients. Conclusions Suboptimal sling location appears to result from incorrect surgical technique, and should be diagnosed and treated early after the primary surgery. Sling location does not change after mid‐term follow up.