Long-term outcomes of autologous pubovaginal fascia slings: Is there a difference between primary and secondary slings?

Lee, Dominic; Murray, Sunshine; Bacsu, Chasta; Zimmern, Philippe E.

doi:10.1002/nau.22502

Cited by 17 publications

(6 citation statements)

References 28 publications

(47 reference statements)

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“…The treatment of SUI using autologous fascia is not a recent technique, having been introduced and popularized by McGuire and Lytton in 1970s . The pubovaginal autologous sling was the foundation of surgical treatment for SUI prior to introduction of the synthetic midurethral sling . Since the FDA warnings, however, new studies of autologous material for SUI treatment in women have been carried out.…”

Section: Discussionmentioning

confidence: 99%

Autologous transobturator sling as an alternative therapy for stress urinary incontinence

Laufer

Scasso

Bentancor

et al. 2019

Intl J Gynecology & Obste

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Objective To evaluate efficacy and outcomes of the autologous transobturator midurethral sling for treatment of stress urinary incontinence (SUI). Methods In a prospective cohort study, an autologous transobturator mid‐urethral sling was used to treat SUI among women attending a university hospital in Montevideo, Uruguay, from June 2017 to July 2018. In the first phase, autologous tissue of the abdominis rectus fascia was collected. In the second phase, the midurethral sling was placed via the transobturator approach. Outcomes were measured every 3 months by the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms (ICIQ‐FLUTS) Score. Preoperative and postoperative results were compared by Wilcoxon test. Results Eighteen women with a median age of 51 years were enrolled. The median follow‐up was 9 months (range 6–15 months). Overall, 17 women showed symptomatic improvement after the procedure. In a comparison of preoperative versus postoperative ICIQ‐FLUTS questionnaires, improvement in the incontinence subscore was observed at 3 (P<0.001), 6 (P<0.001), and 12 (P=0.008) months. No severe complications were observed. Conclusion Use of an autologous transobturator urethral sling was found to be technically feasible and safe for SUI, with good short‐term outcomes. Longer follow up and larger series are needed to validate the procedure.

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Section: Discussionmentioning

confidence: 99%

Autologous transobturator sling as an alternative therapy for stress urinary incontinence

Laufer

Scasso

Bentancor

et al. 2019

Intl J Gynecology & Obste

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“…Lee et al reported a success rate of secondary fascial slings of 65.7% using patient-reported outcomes and no reoperation as a definition of success [27]. Amaye-Obu and Drutz had reported objective and subjective cure rates for abdominovaginal polypropylene sling of 78% and 89%, "modified" urethral sling of 70% and 96%, and colposuspension of 73% and 88% respectively.…”

Section: Discussionmentioning

confidence: 99%

Recurrent stress urinary incontinence surgery in the United Kingdom: an analysis of the British Society of Urogynaecology database (2007–2015)

El‐Hamamsy

Tincello

2020

Int Urogynecol J

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Introduction and hypothesis There is a lack of robust evidence guiding treatment options for recurrent stress urinary incontinence (SUI) and limited comparative outcome data. The aim of this study was to examine the pattern of surgery for recurrent SUI performed by gynaecologists in the UK and compare subjective success rates. Methods Retrospective review of the British Society of Urogynaecologists database for patients having repeat incontinence procedures (2007-2015) including the number of each procedure and outcome recorded by the International Consultation on Incontinence Urinary Incontinence Short Form (ICIQ-UI-SF) questionnaire. Procedures were compared by year and outcomes by operation. Categorical comparisons were performed using Chi-squared test and numerical comparisons using appropriate non-parametric tests. Results A total of 2,938 records were obtained (269 were excluded) and 2,164 women (88.8%) had undergone one previous procedure, most commonly retropubic midurethral sling (MUS; 28.6%). Pelvic floor exercises were offered to 76.2% women. Urodynamic investigation was carried out in 96.2% women: 76.5% had urodynamic stress incontinence. Repeat MUS was the most common procedure (77.3%), followed by bladder neck injections (BNI; 10.2%). Follow-up details were available for 66.1%. Outcome data were poorly reported. Median ICIQ-UI-SF score fell from 16 (0-21) to 0 (0-21) (p < 0.001), 81.6% felt "much better" or "very much better" on Patient Global Impression of Improvement (PGI-I), and 89.3% "cured" or "improved". MUS, colposuspension and fascial sling showed the best results with regard to the PGI-I score and "change in SUI" (p < 0.001). Conclusion MUS and BNI were the most common repeat continence procedures. Follow-up data suggest that MUS, colposuspension and fascial sling are most effective.

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“…This situation affected 11% of our patients, while the majority (72%) had normal voiding characteristics on UDS after MUSR. In the group with normal voiding function, there was less concern in offering an autologous fascia sling than in those with UDA or Valsalva voiding . In the group with UDA or Valsalva voiding, injectable therapy was preferred over pubovaginal sling.…”

Section: Discussionmentioning

confidence: 99%

Urodynamics for incontinence after midurethral sling removal

Çoşkun

Lavelle

Alhalabi

et al. 2015

Neurourology and Urodynamics

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Long-term outcomes of autologous pubovaginal fascia slings: Is there a difference between primary and secondary slings?

Abstract: At long-term follow-up of average 7.4 years, primary and secondary PVS patients had comparable favourable functional outcomes with low morbidity. However, secondary PVS patients had lower success rates as per our definition with higher rate of additional procedures.

Cited by 17 publications

References 28 publications

Autologous transobturator sling as an alternative therapy for stress urinary incontinence

Autologous transobturator sling as an alternative therapy for stress urinary incontinence

Recurrent stress urinary incontinence surgery in the United Kingdom: an analysis of the British Society of Urogynaecology database (2007–2015)

Urodynamics for incontinence after midurethral sling removal

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