Repeat midurethral sling treatment for prior midurethral sling failure

Abstract

We reviewed articles in the PubMed database which describe the results and outcome of a repeat midurethral synthetic sling (MUS), known as tension-free vaginal tape (TVT), or transobturator tape/tension-free vaginal tape obturator for prior MUS failure in patients who presented with persistent or recurrent stress urinary incontinence (SUI). We combined or separated the keywords "TVT," "failure," "repeat TVT," and "recurrent/ persistent SUI." The search was limited by publication data from 2000 to 2010, humans, female, and English text. A repeat TVT procedure treating prior TVT failure showed success rates ranging from 70% to 90%. The outcomes showed no significant differences between a repeat retropubic route or transobturator route. A repeat MUS procedure for persistent or recurrent stress urinary incontinence is a reliable option for patients with prior MUS failure.

Complications Following the Insertion of Two Synthetic Mid‐urethral Slings and Subsequent Removal

“…There are a growing number of reports in women treated with a second synthetic MUS for persistent/recurrent SUI following an initial failed MUS . Despite this escalating trend, very little is known on those who are non‐improved from two MUS and the consequent management of such failures.…”

Management of Recurrent or Persistent Stress Urinary Incontinence after Mid‐urethral Sling

“…Many factors may be related to sling failure, including intrinsic sphincter deficiency (ISD), urethral hypermobility, 10 inadequate tape material, 11 obesity, presence of mixed incontinence, 12 and inadequate surgical technique, whereby the sling is not placed at the mid‐urethra or is applied too loosely 13 . However, different studies often provide contradictory results, indicating that the etiology of MUS failure is uncertain, and making it difficult to determine how best to treat failed slings.…”