INTRODUCTION: There are few data concerning the results of the treatment of recurrent stress urinary incontinence (SUI) after redo mid-urethral sling (MUS) procedure.
METHODS: Retrospective study concerning 34 patients presenting with recurrent SUI following the placement of a first MUS procedure and who have undergone a second MUS procedure. Results were evaluated objectively (cough stress test) and subjectively using international consultation on incontinence questionnaire-short form (ICIQ-SF).
RESULTS: The surgical technique for the placement of the first MUS was a retropubic approach in seven (20.5%) cases and a transobturator approach in 27 (79.5%) cases. Concerning the redo MUS procedure, a retropubic procedure was performed in 25 (73.5%) patients and a transobturator procedure in nine (26.5%) patients. Among the 34 patients, 32 (94%) were re-examined at 2 months follow-up, and contacted through telephone after 1-year follow-up. Post-operatively, the cough stress test revealed no urine leakage in 27/32 (84%) patients. Median follow-up was 15.5 months. ICIQ-SF score was 0 (complete continence) in 19/32 (59%) patients; between 4 and 12 in 11/32 (34%) and between 13 and 20 in 2/32 (6%) patients. A bladder injury was diagnosed during the surgical procedure in two patients. A reintervention was required in 2/34 (5%) patients because of postoperative urinary retention or bladder outlet obstruction. A partial sling resection was required in 2/34 (5%) patients because of vaginal exposure of the synthetic sling.
CONCLUSION: In this study, redo MUS procedure was associated with good functional results despite a high rate of complications.
Written by:
Thubert T, Ait Hammou-Sadi F, Faivre E, Trichot C, Fernandez H, Deffieux X. Are you the author?
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
Reference: Prog Urol. 2013 Apr;23(4):262-9.
doi: 10.1016/j.purol.2013.01.020
PubMed Abstract
PMID: 23544984
Article in French.
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