Risk factors for failure of repeat midurethral sling surgery for recurrent or persistent stress urinary incontinence

Lo, Tsia‐Shu; Pue, Leng Boi; Tan, Yiap Loong; Wu, Pei‐Ying

doi:10.1007/s00192-015-2912-5

Cited by 17 publications

(12 citation statements)

References 28 publications

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“…This explains how age was a significant risk factor for failure in the study. Lo et al [27] supported that poor urethral function and bladder neck hypomobility can lead to failure of the midurethral sling. Success of midurethral sling surgeries depends on the sling acting as a fulcrum for dynamic kinking to occur during Valsalva maneuver or increased abdominal pressure [28].…”

Section: Figmentioning

confidence: 99%

Five-Year Outcome of MiniArc Single-Incision Sling Used in the Treatment of Primary Urodynamic Stress Incontinence

Chua

Kao

et al. 2018

Journal of Minimally Invasive Gynecology

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Section: Figmentioning

confidence: 99%

Five-Year Outcome of MiniArc Single-Incision Sling Used in the Treatment of Primary Urodynamic Stress Incontinence

Chua

Kao

et al. 2018

Journal of Minimally Invasive Gynecology

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“…Hence the key is certainly the clinical portion of the ISD definition with the presence of a fixed urethra. Indeed, midurethral sling placement has been shown to be less effective in these cases despite its continued use in clinical practice . AUS is only one of the several options that have been investigated in the treatment of female patients with SUI resulting from ISD, with an armamentarium including bulking agents, adjustable slings, Adjustable continence therapy periurethral balloons, or pubovaginal fascial slings .…”

Section: Discussionmentioning

confidence: 99%

AMS‐800 Artificial urinary sphincter in female patients with stress urinary incontinence: A systematic review

Peyronnet¹,

O’Connor²,

Khavari³

et al. 2018

Neurourology and Urodynamics

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Aims To perform a systematic review of studies reporting the outcomes of AMS‐800 artificial urinary sphincter (AUS) implantation in female patients with stress urinary incontinence (SUI) resulting from intrinsic sphincter deficiency (ISD). Methods A systematic literature search of the Medline and Embase databases was performed in June 2018 in accordance with the PRISMA statement. No time limit was used. The protocol was registered in PROSPERO (CRD42018099612). Study selection and data extraction were performed by two independent reviewers. Results Of 886 records screened, 17 were included. All were retrospective or prospective non‐comparative case series. One study reported on vaginal AUS implantation, 11 on open AUS implantation, two on laparoscopic AUS implantation, two on robot‐assisted AUS implantation and one compared open and robot‐assisted implantations. The vast majority of patients had undergone at least one anti‐incontinence surgical procedure prior to AUS implantation (69.1‐100%). The intraoperative bladder neck injury rates ranged from 0% to 43.8% and the intraoperative vaginal injury rates ranged from 0 to 25%. After mean follow‐up periods ranging from 5 to 204 months, the complete continence rates ranged from 61.1% to 100%. The rates of explantation, erosion and mechanical failure varied from 0% to 45.3%, 0% to 22.2% and 0% to 44.1%, respectively. Conclusions AMS‐800 AUS can provide excellent functional outcomes in female patients with SUI resulting from ISD but at the cost of a relatively high morbidity. High level of evidence studies are needed to help better define the role of AUS in the female SUI armamentarium.

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“…Hypomobility (Q-tip at maximal straining angle < 30°) is associated with a nearly twofold increase in sling failure [32]. In patients subjected to a repeat sling for recurrent or persistent SUI, limited mobility of the urethra detected by the Q-tip test or by ultrasound increases the risk of an unfavorable outcome more than 4 times [33]. …”

Section: Role Of Ultrasound Imaging In the Clinical Work-up Of Patienmentioning

confidence: 99%

Ultrasound imaging in urogynecology – state of the art 2016

Bogusiewicz

2016

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The role of ultrasound imaging in urogynecology is not clearly defined. Despite significant developments in visualization techniques and interpretation of images, pelvic ultrasound is still more a tool for research than for clinical practice. Structures of the lower genitourinary tract and pelvic floor can be visualized from different approaches: transperineal, introital, transvaginal, abdominal or endoanal. According to contemporary guidelines and recommendations, the role of ultrasound in urogynecology is limited to the measurement of post-void residue. However, in many instances, including planning and audit of surgical procedures, management of recurrences or complications, ultrasound may be proposed as the initial examination of choice. Ultrasound may be used for assessment of bladder neck mobility before anti-incontinence procedures. On rare occasions it is helpful in recognition of pathologies mimicking vaginal prolapse such as vaginal cyst, urethral diverticula or rectal intussusception. In patients subjected to suburethral slings, causes of surgery failure or postsurgical voiding dysfunctions can be revealed by imaging. Many reports link the location of a tape close to the bladder neck to unfavorable outcomes of sling surgery. Some postoperative complications, such as urinary retention, mesh malposition, hematoma, or urinary tract injury, can be diagnosed by ultrasound. On the other hand, the clinical value of some applications of ultrasound in urogynecology, for example measurement of the bladder wall thickness as a marker of detrusor overactivity, has not been proved.

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Risk factors for failure of repeat midurethral sling surgery for recurrent or persistent stress urinary incontinence

Abstract: Repeat MUS surgery is safe and has a good short-term success rate, both objectively and subjectively, with independent risk factors for failure related to bladder neck hypomobility and poor urethral function.

Cited by 17 publications

References 28 publications

Five-Year Outcome of MiniArc Single-Incision Sling Used in the Treatment of Primary Urodynamic Stress Incontinence

Five-Year Outcome of MiniArc Single-Incision Sling Used in the Treatment of Primary Urodynamic Stress Incontinence

AMS‐800 Artificial urinary sphincter in female patients with stress urinary incontinence: A systematic review

Ultrasound imaging in urogynecology – state of the art 2016

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