How do urogynaecologists treat failed suburethral slings? Experience from the British Society of Urogynaecology database and literature review

Patil, A.; Moran, Paul; Duckett, Jonathan

doi:10.3109/01443615.2011.581319

Cited by 17 publications

(10 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This finding was similar to that of a 2011 publication looking at the British Society of Urogynaecology database where 54% of patients with recurrent SUI had a repeat retropubic midurethral sling 18 . Nevertheless, it must be emphasised that the cure rates after a second procedure tend to decline and the risk of de novo overactive bladder syndrome rises 19 .…”

Section: Discussionsupporting

confidence: 86%

Management of recurrent stress urinary incontinence and urinary retention following midurethral sling insertion in women

Hashim

Terry

2012

annals

View full text Add to dashboard Cite

INTRODUCTIONSynthetic midurethral slings are the most common operations performed for women with stress urinary incontinence (SUI). However, there is only very scarce evidence regarding the management of complications from these operations. The aim of this survey was to canvass expert opinion regarding the management of recurrent SUI and urinary retention following insertion of these slings.METHODSExpert urologists and urogynaecologists in the UK with an interest in SUI were identified. Three clinical scenarios on recurrent SUI and one on urinary retention following midurethral sling placements were emailed twice to the experts.RESULTSThe majority of the experts chose a repeat synthetic midurethral retropubic transvaginal tape (TVT) as the procedure of choice for recurrent SUI in patients who had had a previous TVT or midurethral transobturator tape inserted. In patients who continued to suffer SUI after a failed second TVT, there were mixed results with experts choosing fascial slings, colposuspension and bulking agents as their preferred method of treatment. In women who develop urinary retention following a TVT, tape pull-down within two weeks was the preferred method among the experts. However, division of the tape within two to six weeks following the procedure was also popular.CONCLUSIONSBased on expert opinion, it is difficult to make a recommendation as to the best method of treating recurrent SUI or urinary retention following tape insertion. There is an urgent requirement for well conducted, multicentre, randomised clinical trials to look at the management of these complications and also the tools used to assess the patient before salvage surgical management.

show abstract

Section: Discussionsupporting

confidence: 86%

Management of recurrent stress urinary incontinence and urinary retention following midurethral sling insertion in women

Hashim

Terry

2012

annals

View full text Add to dashboard Cite

show abstract

“…We chose to use an autologous facial sling to salvage a failed mesh midurethral sling in order to avoid repeating the same operation while hoping for a different outcome. Many surgeons choose to repeat a type of sling after a failed sling . Nevertheless, there is a paucity of data to strongly recommend one salvage treatment over another, and treatments that are usually considered in this clinical setting include bulking agents; retropubic suspension; and repeat, midurethral or retropubic sling .…”

Section: Discussionmentioning

confidence: 99%

Salvage autologous fascial sling after failed synthetic midurethral sling: Greater than 3‐year outcomes

et al. 2015

View full text Add to dashboard Cite

Objective: To determine long-term surgical outcomes of salvage autologous fascial sling placement after a failed synthetic midurethral sling. Methods: Women who had undergone autologous fascial sling placement without concomitant pelvic surgery for a failed synthetic midurethral sling utilizing mesh with a minimum follow up of 36 months were identified. Charts were reviewed, and patients were contacted by telephone. Success was determined by the Patient Global Impression of Improvement. Secondary measures included the Incontinence Severity Index questionnaire, patient recommendation of the autologous fascial sling and need for further incontinence surgery. Results: A total of 35 patients met the criteria, and 21 were successfully contacted. Of those contacted, the median age at surgery was 67 years (range 53-81 years) and at the time of the survey was 75 years (range 63-84 years) with median follow up of 74 months (range 36-127 years). Preoperatively, 12 patients (57.1%) had urethral hypermobility and 13 patients (61.9%) had mixed urinary incontinence. Eight patients (38.1%) had concomitant sling excision with five of those combined with urethrolysis at the time of the salvage operation. Patient Global Impression of Improvement success was noted in 16 patients (76.2%). A total of 11 patients (52.4%) were dry or had slight incontinence by the Incontinence Severity Index. One patient required additional antiincontinence surgery (4.8%). A total of 18 patients (85.7%) recommended the autologous fascial sling. No statistical impact was noted with sling excision (P = 0.62), mixed urinary incontinence (P = 0.61), age at surgery (P = 0.23), age at follow up (P = 0.15), length of follow up (P = 0.71) or first surgery type (transobturator tape vs retropubic; P = 1.00). Conclusions: Autologous fascial sling provides reasonable long-term success as a salvage operation for failed midurethral slings.

show abstract

“…Repeat midurethral tape has gained popularity over the last few years, and a recent survey among general gynecologists and urogynecologists [30] and a review of a national database in the UK [31] showed that it is the secondary procedure of choice for persistent or recurrent SUI after a failed tape. Small retrospective studies for retropubic tapes (TVT) following a failed midurethral tape have shown subjective cure rates of 71-92% [9][10][11] and objective cure rates of 55-77% [10,12].…”

Section: Discussionmentioning

confidence: 99%

What do we do when a midurethral tape fails? Rediscovery of open colposuspension as a salvage continence operation

et al. 2012

View full text Add to dashboard Cite

show abstract

How do urogynaecologists treat failed suburethral slings? Experience from the British Society of Urogynaecology database and literature review

Cited by 17 publications

References 26 publications

Management of recurrent stress urinary incontinence and urinary retention following midurethral sling insertion in women

Management of recurrent stress urinary incontinence and urinary retention following midurethral sling insertion in women

Salvage autologous fascial sling after failed synthetic midurethral sling: Greater than 3‐year outcomes

What do we do when a midurethral tape fails? Rediscovery of open colposuspension as a salvage continence operation

Contact Info

Product

Resources

About