Are We Satisfied? Perspective on Five-year Outcomes of Midurethral Slings

Brubaker, Linda; Brincat, Cynthia

doi:10.1016/j.eururo.2014.02.002

Cited by 4 publications

(1 citation statement)

References 1 publication

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“…7 For women undergoing surgery to treat SUI, the long-term outcome probably means decades; however, there is little evidence-based research with adequate methodology that reports results beyond 5 years. 8 It is important to establish the efficacy and long-term complications of urogynecolog-ical surgical treatments, especially for those procedures that use meshes. Collection and publication of data regarding the possible long-term complications related to the use of prosthetic materials is critical.…”

Section: Introductionmentioning

confidence: 99%

Five-year Follow-up of Transobturator Sling: 152 Cases with the Same Surgeon

Diniz

Silva

et al. 2018

Rev Bras Ginecol Obstet

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Objective To evaluate the long-term subjective cure rate of the transobturator sling, including an analysis of the risk factors and of the impact of increased surgical experience on the results. Methods A retrospective cohort study of women who underwent transobturator sling surgery from 2005 to 2011 was conducted. Patients were evaluated by a telephone survey using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and by subjective questions regarding satisfaction. An ICIQ-SF score of 0 was considered a cure. The crude and adjusted odds ratios and 95% confidence intervals were estimated in univariate and multivariate logistic regression models to identify risk factors for surgical failure. Differences with p < 0.05 were considered significant. Results In total, 152 (70.6%) patients answered the questionnaire. The median follow-up period was 87 months. The urodynamic diagnosis was stress urinary incontinence in 144 patients (94.7%), and mixed urinary incontinence in 8 (5.3%) patients. Complications occurred in 25 (16%) patients. The ICQ-SF results indicated that 99 (65.10%) patients could be considered cured (ICIQ-SF score = 0). Regarding the degree of satisfaction, 101 (66%) considered themselves cured, 43 (28%) considered themselves improved, 7 (4.6%) considered themselves unchanged, and one reported worsening of the incontinence. After the univariate and multivariate analyses, the primary risk factor for surgical failure was the presence of urgency (p < 0.001). Conclusion The transobturator sling is effective, with a low rate of complications and a high long-term satisfaction rate. The risk factors for failure were the presence of urgency and patient age. The increased experience of the surgeon was not a factor that influenced the rate of complications.

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Section: Introductionmentioning

confidence: 99%

Five-year Follow-up of Transobturator Sling: 152 Cases with the Same Surgeon

Diniz

Silva

et al. 2018

Rev Bras Ginecol Obstet

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Mid-urethral sling operations for stress urinary incontinence in women

Ford

Rogerson

Cody

et al. 2015

Cochrane Database of Systematic Reviews

236

192

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Mid-urethral sling operations have been the most extensively researched surgical treatment for stress urinary incontinence (SUI) in women and have a good safety profile. Irrespective of the routes traversed, they are highly effective in the short and medium term, and accruing evidence demonstrates their effectiveness in the long term. This review illustrates their positive impact on improving the quality of life of women with SUI. With the exception of groin pain, fewer adverse events occur with employment of a transobturator approach. When comparing transobturator techniques of a medial-to-lateral versus a lateral-to-medial insertion, there is no evidence to support the use of one approach over the other. However, a bottom-to-top route was more effective than top-to-bottom route for retropubic tapes.A salient point illustrated throughout this review is the need for reporting of longer-term outcome data from the numerous existing trials. This would substantially increase the evidence base and provide clarification regarding uncertainties about long-term effectiveness and adverse event profile.

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Mid-urethral sling operations for stress urinary incontinence in women

Ford

Rogerson

Cody

et al. 2017

Cochrane Database of Systematic Reviews

432

394

View full text Add to dashboard Cite

Mid-urethral sling operations have been the most extensively researched surgical treatment for stress urinary incontinence (SUI) in women and have a good safety profile. Irrespective of the routes traversed, they are highly effective in the short and medium term, and accruing evidence demonstrates their effectiveness in the long term. This review illustrates their positive impact on improving the quality of life of women with SUI. However, a brief economic commentary (BEC) identified three studies suggesting that transobturator may be more cost-effective compared with retropubic. Fewer adverse events occur with employment of a transobturator approach with the exception of groin pain. When comparing transobturator techniques of a medial-to-lateral versus a lateral-to-medial insertion, there is no evidence to support the use of one approach over the other. However, a bottom-to-top route was more effective than top-to-bottom route for retropubic tapes.A salient point illustrated throughout this review is the need for reporting of longer-term outcome data from the numerous existing trials. This would substantially increase the evidence base and provide clarification regarding uncertainties about long-term effectiveness and adverse event profile.

show abstract

Are We Satisfied? Perspective on Five-year Outcomes of Midurethral Slings

Cited by 4 publications

References 1 publication

Five-year Follow-up of Transobturator Sling: 152 Cases with the Same Surgeon

Five-year Follow-up of Transobturator Sling: 152 Cases with the Same Surgeon

Mid-urethral sling operations for stress urinary incontinence in women

Mid-urethral sling operations for stress urinary incontinence in women

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