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Tension‐free vaginal tape retropubic sling for recurrent stress urinary incontinence after Burch colposuspension failure
Author(s) -
Shao Yuan,
He Hongchao,
Shen Zhoujun,
Zhou Wenlong
Publication year - 2011
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/j.1442-2042.2011.02755.x
Subject(s) - medicine , sling (weapon) , urinary incontinence , urology , stress incontinence , surgery , sphincter , ambulatory
Objectives: To verify the efficacy and to clarify the mechanism of the tension‐free vaginal tape retropubic sling for recurrent stress urinary incontinence after Burch colposuspension failure. Methods: A total of 24 women having tension‐free vaginal tape retropubic sling placement for recurrent stress urinary incontinence after a previous failed Burch urethropexy were enrolled in the present study. Median follow up was 57 months (range 12–96). Pre‐ and postoperative urethral mobility and urodynamics were evaluated. Results: Preoperatively, all 24 patients had intrinsic sphincter deficiency and 14 had urethral hypermobility. Postoperatively, 15 patients were completely dry and two had a leakage of urine less than 5 g/h. The overall success rate was 70.8%. There was a significant postoperative increase of maximum urethral closure pressure ( P < 0.001), and a decrease of average flow rate ( P = 0.001) and urethral hypermobility ( P < 0.001). When comparing successful with failure cases, only elevated maximum urethral closure pressure ( P = 0.002) was significantly different. Multivariate logistic regression showed the change of maximum urethral closure pressure ( P = 0.011) was the only independent parameter significantly correlated with the outcome of sling placement. Conclusions: Recurrent stress urinary incontinence with intrinsic sphincter deficiency after Burch colposuspension might be well treated with the tension‐free vaginal tape retropubic sling by effectively elevating the maximum urethral closure pressure.