They found 35 patients of median age 54(33-82) years were identified, with the median time between tape insertion to removal of 5(1-15) years. Procedures performed to manage urethral complications, any simultaneous and subsequent interventions are shown in Table 1.
Pre-operative urodynamics showed SUI in 18/35 (51%), DO wet in 4/35 (11%), and DO dry in 4/35 (11%). 26/35 (74%) had repeat VUDS assessment; 21/26 (81%) had recurrent/persistent SUI, 5/26 (19%) had recurrent/persistent mixed urinary incontinence (MUI) and 5 (19%) had DO dry. 20/34 (59%) went on to have further SUI surgery with cure or improvement in 15/20 (75%). 13 women had rectus fascial sling -9 are dry or improved. 5 had colposuspension -4 are dry or improved. 1 had Bulkamid injection and 1 had bladder artificial urinary sphincter - both are dry.Women who had persistent significant SUI had a minimum of 2 previous surgical procedures for SUI prior to their index MUT insertion. Both women who had simultaneous procedures for SUI at time of management of their tape complication also suffered persistent significant SUI.
They concluded that vaginal removal of MUT, urethral repair and modified Martius labial fat pad interposition results in resolution of pain and a useable urethra in 97%. SUI persists or recurs in 74%. 59% require further SUI surgery, which has a 75% success rate. It is important to counsel patients having surgery for tape related urethral complications accurately regarding functional outcomes and the need for further interventions
Presented by: Bogdan Toia, London, United Kingdom
Co- authors: Neha Sihra, Mahreen Pakzad, Rizwan Hamid, Jeremy Ockrim, Tamsin Greenwell, London, United Kingdom
Written by: Bilal Farhan, MD, Clinical Instructor, Female Urology and Voiding Dysfunction, Department of Urology, University of California, Irvine Twitter: @BilalfarhanMD at American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois