To determine the significance of bladder trabeculations seen on preoperative cystoscopy prior to midurethral sling surgery with respect to lower urinary tract symptoms and sling outcomes.
This retrospective study included women with preoperative cystoscopy who underwent midurethral slings for urinary incontinence from 2006-2009.
Cystoscopic findings of bladder trabeculations, as well as pre and postoperative urinary symptoms were recorded Patients with and without bladder trabeculations were compared with respect to baseline characteristics, lower urinary tract symptoms, and sling outcomes
Of the 241 women included in the study, 14 9% had trabeculations on preoperative cystoscopy At baseline, women with trabeculations were more likely to be older (64 8 years versus 57 8 years, p < 0 01), and have lower mean maximum cystometric capacity (341 mL +/- 136 versus 436 mL +/- 148, p < 0 01), compared to those without trabeculations More women with trabeculations had mixed incontinence (p < 0 01) and less pure stress incontinence (p < 0 01) preoperatively There was no difference between women with and without trabeculations with respect to pre and postoperative symptoms of urgency, frequency, and nocturia Women with preoperative trabeculations were more likely to have preoperative treatment with anticholinergics (p = 0 02) and had a three times higher risk of postoperative sling failure (HR 2 95 [CI 1 11-7 85], p = 0 03)
Preoperative cystoscopic bladder trabeculations are associated with significantly higher rate of midurethral sling failure Trabeculations were not associated with pre or postoperative lower urinary tract symptoms
The Canadian journal of urology 2015 Aug [Epub]
Ladin A Yurteri-Kaplan, Danielle D Antosh, Cheryl B Iglesia, Andrew I Sokol, David Shveiky, Robert E Gutman
Section of Female Pelvic Medicine and Reconstructive Surgery, MedStar Washington Hospital Center/ Georgetown University School of Medicine, Washington, DC, USA