Outcomes of Autologous Fascia Pubovaginal Sling for Patients with Transvaginal Mesh Related Complications Requiring Mesh Removal

McCoy, Olugbemisola Oredein; Vaughan, Taylor; Nickles, Samuel; Ashley, Matt; MacLachlan, Lara S.; Ginsberg, David A.; Rovner, E.S.

doi:10.1016/j.juro.2016.02.2976

Cited by 20 publications

(13 citation statements)

References 18 publications

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“…To our knowledge, concomitant pubovaginal sling at the time of sling excision has been reported in only three series to date. [12][13][14] Starkman et al 14 This may be due to the extensive dissection or tape excision performed in our cohort, with removal of all the portion of tape accessible through a transvaginal approach, compared with sling incision or limited excision usually performed for example in case of bladder outlet obstruction. The extent of the tape removed at the time of sling revision is probably a key determinant of SUI recurrence.…”

Section: Discussionmentioning

confidence: 89%

“…Continence rates of 71% were reported, although Shah et al did not distinguish between those with concomitant repair or not. More recently, in the largest series to date, McCoy et al reported similar success rates in 30 patients with concomitant pubovaginal sling and 16 patients with staged AFPVS after sling revision (80% vs 69%), but indications for revision surgery were heterogeneous (only 33% of perforation). Hence, our findings confirm those of previous series and suggest, for the first time, that the concomitant versus staged AFPVS placement may provide similar outcomes in the specific setting of tape excision for sling perforation.…”

Section: Discussionmentioning

confidence: 91%

“…To our knowledge, concomitant pubovaginal sling at the time of sling excision has been reported in only three series to date . Starkman et al reviewed 19 patients who had undergone removal of MUS for treatment of sling perforation and exposure and reported recurrent SUI in 42% of patients.…”

Section: Discussionmentioning

confidence: 99%

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Exploring stress urinary incontinence outcomes after sling excision for perforation or exposure

Syan

Peyronnet

Drain

et al. 2019

LUTS

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Objective This study assessed stress urinary incontinence (SUI) outcomes after sling excision for urinary tract perforation or vaginal exposure, and compared the outcomes of concomitant versus staged autologous fascia pubovaginal sling (AFPVS). Methods A retrospective chart review of all patients who underwent midurethral sling (MUS) excision for urinary tract perforation or vaginal exposure at a tertiary referral center between 2010 and 2015 was performed. Therapeutic strategies were categorized as concomitant AFPVS, staged AFPVS, and no anti‐incontinence procedure. Results In all, 32 patients were included for analysis: 13 with vaginal tape exposure (40.6%) and 19 with urinary tract tape exposure (59.4%). In patients who had SUI prior to sling excision (43.8%), the rate of resolved or improved SUI postoperatively was higher in the concomitant AFPVS group than in those who underwent sling excision alone (83.3% vs 12.5%, respectively; P = 0.03). Of 18 patients with no SUI prior to sling excision, 12 experienced recurrent SUI after sling removal (66.7%). The rate of recurrent SUI was lower in patients with vaginal MUS exposure than urinary tract MUS perforation, but this did not reach statistical significance (57.1% vs 72.7%, respectively; P = 0.63). The rates of resolved SUI after AFPVS were comparable in patients with concomitant and staged AFPVS (66.7% vs 71.4%, respectively; P = 0.99). Conclusions Many patients with MUS perforations or exposures will have SUI at initial presentation or develop SUI after removal of the synthetic sling. The decision to perform a concomitant AFPVS or to stage the surgical management of SUI can be individualized.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 91%

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Exploring stress urinary incontinence outcomes after sling excision for perforation or exposure

Syan

Peyronnet

Drain

et al. 2019

LUTS

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“…Currently, there is no data available in the literature reporting the outcomes of artificial urinary sphincter after SSR. McCoy et al 16 reported on the outcomes of autologous fascial pubovaginal sling as a salvage procedure for recurrent stress incontinence after removal of polypropylene mesh erosion/exposure and/or bladder outlet obstruction in women treated with prior transvaginal synthetic mesh for SUI. At a mean follow‐up of 16 months 42 of 46 patients (91%) and 35 of 46 (76%) had achieved objective and subjective success, respectively.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Macroplastique injections for stress urinary incontinence after suburethral sling removal

Rodríguez

Carroll

Alhalabi

et al. 2020

Neurourology and Urodynamics

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Introduction To evaluate outcomes following urethral Macroplastique (MPQ) injection in women with stress urinary incontinence (SUI) following suburethral sling removal (SSR) for synthetic sling complications. Methods Following Institutional Review Board approval, charts of non‐neurogenic women with SUI after SSR who underwent MPQ injection(s) and had at least 6 months minimum follow‐up were reviewed from a prospectively maintained database. Demographic data, questionnaire (Urogenital Distress Inventory‐6 [UDI‐6] and Quality of Life) scores, and pad usage were recorded. Patients were followed with repeat questionnaires and three‐dimensional ultrasound evaluating MPQ volume. Success following MPQ was defined as a composite score of a UDI‐6 question 3 score of 0 to 1 at last visit and no additional anti‐incontinence therapy. Results From 2011 to 2018, 70 women with mean age 62.7 years met study criteria. At a mean follow‐up of 46.4 ± 1.5 months, the success rate after the first MPQ injection was 46%. Following a repeat MPQ injection when indicated, the overall success rate for the entire cohort was 69%. Despite the objective failure, the majority of patients reported subjective improvement (83%) and reduced pad usage (78%). On multivariate analysis: age, body mass index, previous hysterectomy, hormone replacement therapy, type of sling removed and baseline urodynamics (UDS) parameters were not predictors of MPQ failure. Higher parity was a predictor of MPQ failure (hazard ratio = 1.980; P = .032). Conclusion MPQ injection is a durable and effective management option for SUI following SSR, although a second injection may be required to achieve the desired success.

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“…13 The autologous fascial pubovaginal sling was considered as a salvage procedure for recurrent stress incontinence after mesh erosion/exposure and/or bladder outlet obstruction in patients treated with prior transvaginal synthetic mesh for stress urinary incontinence. [14][15][16] In this study, we are going to compare between tensionfree trans obturator vaginal tape (TVT-O) using synthetic polypropylene macro porous monofilament mesh and autologous rectus fascia trans obturator vaginal sling as treatment modalities of female stress urinary incontinence.…”

Section: Introductionmentioning

confidence: 99%

Tension-free transobturator vaginal tape and autologous rectus fascia transobturator vaginal sling for the treatment of urinary stress incontinence: a prospective clinical study

Elsersy

2017

Int J Reprod Contracept Obstet Gynecol

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Original Research ArticleTension-free transobturator vaginal tape and autologous rectus fascia transobturator vaginal sling for the treatment of urinary stress incontinence: a prospective clinical study Mervat A. Elsersy* INTRODUCTIONStress urinary incontinence (SUI) is a common disorder affecting adult females due to weak mechanisms of urethral closure. 1,2 Behavioral changes and pelvic floor muscle training are considered conservative nonsurgical options for treatment. [3][4][5] Tension-free vaginal tape has become a popular method for surgical treatment of urodynamically proven stress incontinence (USI), since it was introduced by Ulmsten in 1995. The retro pubic approach of tension-free vaginal tape (RT-TVT) procedure was widely accepted worldwide as the standard surgical treatment for SUI. 6 Tension free vaginal sling procedures had achieved good long-term success together with lower complication rates; but they had some failure rate due to either excessive or failure to achieve the desired tension, which resulted in voiding difficulties or urinary leakage persistence, respectively. 7Transobturator route (TVT-O) was considered as the second-generation, utilizing either outside-in or inside-out approaches, so avoiding the passage into the retro pubic ABSTRACT Background: A large proportion of adult women complain of urinary incontinence, which has considerable drawbacks on their quality of life and social incorporation in the community. Conservative measures had been tried for several decades but with limited efficacy in huge proportion of patients. Vaginal sling procedures, since it was introduced in medical field had achieved good success rates with low complication rates. However, they still cause problems. Since Ulmsten introduced the tension-free vaginal tape in 1995, it has become a popular method for surgical treatment of urodynamically proven USI. In this study, we are going to compare between tension-free Trans obturator vaginal tape (TVT-O) using synthetic polypropylene macro porous monofilament mesh and autologous rectus fascia Trans obturator sling. Methods: 80 patients had stress urinary incontinence were randomly assigned to either group (1) who underwent insertion of synthetic tension free vaginal tape using (Aris-Transobturator Sling System) or group to (2) to whom autologous rectus fascia transobturator vaginal sling was applied. Results: Objective and subjective cure rates were comparable in both groups, but patients in group (1) had shorter operative time and less duration of post-operative catheterization. Patients in group (1) were statistically more satisfied than patients in group (2). Conclusions: Both techniques are effective in the treatment of female stress incontinence.

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Outcomes of Autologous Fascia Pubovaginal Sling for Patients with Transvaginal Mesh Related Complications Requiring Mesh Removal

Abstract: Autologous fascial pubovaginal sling placement after synthetic mesh removal can be performed successfully in patients with stress urinary incontinence as a single or staged procedure.

Cited by 20 publications

References 18 publications

Exploring stress urinary incontinence outcomes after sling excision for perforation or exposure

Exploring stress urinary incontinence outcomes after sling excision for perforation or exposure

Outcomes of Macroplastique injections for stress urinary incontinence after suburethral sling removal

Tension-free transobturator vaginal tape and autologous rectus fascia transobturator vaginal sling for the treatment of urinary stress incontinence: a prospective clinical study

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