Risk factors of treatment failure of midurethral sling procedures for women with urinary stress incontinence

Stav, Kobi; Dwyer, Peter; Rosamilia, Anna; Schierlitz, Lore; Lim, Yujin; Lee, Joseph

doi:10.1007/s00192-009-1020-9

Cited by 120 publications

(97 citation statements)

References 25 publications

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“…Some other studies indicated these variables as independent risk factors for surgical outcome (14,15,16). In a recent study, it was reported that concomitant prolapse surgery decreased the likelihood of surgical failure after MUS (14), and that concurrent prolapse surgery, taking anticholinergic medications preoperatively and increased age were independent risk factors affecting successful outcome after MUS (16).…”

Section: Discussionmentioning

confidence: 98%

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What are the Predictive Factors of the Cure and Complication Rates for Midurethral Slings in the Treatment of Stress Urinary Incontinence in Women: A Multicenter and Multivariate Analysis Study

Çitgez¹,

Demi̇rkesen²,

Mangır³

et al. 2017

jus

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What's known on the subject? and What does the study add? Öz Amaç: Kadınlarda stres tip idrar kaçırma (STİK) tedavisinde midüretral sling (MUS) uygulanmasının sonuç ve komplikasyon oranlarını etkileyen prediktif faktörleri araştırdık. Gereç ve Yöntem: Ürodinamik STİK tespit edilip MUS uygulanan 594 kadın hasta (285 transobturator dıştan içe, 91 transobturator içten dışa, 218 retropubik) araştırıldı. Ortalama yaş 53,9 (27-82) idi. Univaryan analizde ki-kare, Student-t ve Mann-Whitney U testleri kullanıldı. Multivaryan Objective: Predictive factors that could affect the cure and complication rates of midurethral slings (MUS) in the treatment of stress urinary incontinence (SUI) were investigated. Materials and Methods: A total of 594 women (outside-in transobturator in 285, inside-out transobturator in 91, and retropubic in 218) with SUI and who had undergone MUS were evaluated. The median age was 53.9 (27-82) years. Univariate analyses were done using chi-square test, Student's t-test and the Mann-Whitney U test. Multivariate analyses were done using logistic regression analysis to determine predictive factors affecting cure and complication rates. Results: The mean follow-up time was 48 months. The subjective cure rate was 84% and complication rate was 11.2%. On univariate and multivariate analyses, the cure rate was found to be increased in younger patients [odds ratio (OR): 0.97, 95% confidence interval (CI): 0.95-0.99, p=0.038] and in patients with pure SUI (OR: 2.17, 95% CI: 1.31-3.60, p=0.002). The type of surgery was the only statistically significant parameter affecting the complication rate, which was significantly higher in retropubic MUS procedure (OR: 6.28, 95% CI: 3.51-11.22, p<0.001). Conclusion: MUS is an effective and safe surgical procedure in the treatment of SUI. In this study, age and type of incontinence were the only significant predictive factors affecting the cure rate. Our study suggests that retropubic approach could be considered a risk factor for complication after MUS.

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Section: Discussionmentioning

confidence: 98%

“…There are studies assessing the risk factors affecting cure and complication rates after MUS (14,15,16 and the cure rate was significantly lower in TVT patients over 55 years of age (18). However, there are also several studies that have demonstrated satisfactory outcomes after TVT in elderly patients (19,20).…”

Section: Discussionmentioning

confidence: 99%

What are the Predictive Factors of the Cure and Complication Rates for Midurethral Slings in the Treatment of Stress Urinary Incontinence in Women: A Multicenter and Multivariate Analysis Study

Çitgez¹,

Demi̇rkesen²,

Mangır³

et al. 2017

jus

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show abstract

“…The presence of pelvic organ prolapse and its correction did not significantly affect the cure rates [42]. In fact, a number of studies have shown that concomitant prolapse surgery decreases the likelihood of surgical failure after MUSs [55].…”

Section: Comparative Studies Of Tvt With the Transobturator Tapementioning

confidence: 92%

“…Risk factors for failure have been analyzed and were reported to be similar in the retropubic and transobturator MUSs. Stav et al [55] studied 1,225 women following MUS; multivariate analysis revealed that body mass index >25 (odds ratio (OR), 2.9), mixed incontinence (OR, 2.4), previous continence surgery (OR, 2.2), ISD (OR, 1.9), and diabetes mellitus (OR, 1.8) are significant independent predictors for MUS failure. Concomitant prolapse surgery decreased the likelihood of surgical failure after MUS (OR, 0.6).…”

Section: Management Of Recurrent Suimentioning

confidence: 99%

Recent Developments in the Surgical Management of Urinary Stress Incontinence

Ahn

Alvarez

Dwyer

2013

Curr Obstet Gynecol Rep

Self Cite

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Surgical management continues to be the mainstay of treatment for patients with moderate to severe stress urinary incontinence who are nonresponsive to conservative measurements. In the past, the Burch colposuspension was considered the first line of treatment; however, since the introduction of mid-urethral slings in the mid 1990s the retropubic sling has become the "gold standard." Tension-free vaginal tape (TVT) is the original retropubic procedure with good long-term efficacy and safety data available. However, in an attempt to decrease the risk of retropubic complications, such as vascular, bowel, or bladder injury, the transobturator and single incision minislings have been described. In this review, we give an overview on the recent data available on conventional anti-incontinence procedures as well as other more recently developed procedures. Recent studies with more than 10 years of follow-up continue to confirm the effectiveness of the TVT sling in the long-term, which the other approaches need to match.

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“…In 2012, Stav et al examined data from 1225 consecutive women with SUI receiving an MUS (955 retropubic and 270 transobturator) at their institution between 1999 and 2007. 3 Multivariate analysis showed that body mass index greater than 25 kg/m 2 , mixed incontinence, previous continence surgery, intrinsic sphincter deficiency, and diabetes are significant independent predictors for MUS failure. Conversely, patients undergoing concomitant prolapse surgery were at significantly lower risk of MUS failure (Table 1).…”

Section: Identification Of Patients At Risk For Failurementioning

confidence: 93%

Evaluation and management of the patient with a failed midurethral synthetic sling

Gormley

2012

CUAJ

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While most women will do well following placement of a midurethral sling (MUS), a substantial minority do experience surgical failure. There are several risk factors that can help identify a patient at higher risk for failure, including body mass index greater than 25 kg/m 2 , mixed incontinence, previous continence surgery, intrinsic sphincter deficiency, and diabetes. At the present time, there is no evidence-based guidance for which intervention to use following failure. Careful evaluation of patient characteristics will help guide subsequent management.

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Risk factors of treatment failure of midurethral sling procedures for women with urinary stress incontinence

Cited by 120 publications

References 25 publications

What are the Predictive Factors of the Cure and Complication Rates for Midurethral Slings in the Treatment of Stress Urinary Incontinence in Women: A Multicenter and Multivariate Analysis Study

What are the Predictive Factors of the Cure and Complication Rates for Midurethral Slings in the Treatment of Stress Urinary Incontinence in Women: A Multicenter and Multivariate Analysis Study

Recent Developments in the Surgical Management of Urinary Stress Incontinence

Evaluation and management of the patient with a failed midurethral synthetic sling

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