To evaluate the performance of retropubic midurethral slings (MUS) for the treatment of female stress urinary incontinence (SUI) of a certified continence center and to identify risk factors for sling failure.
This was a single-center cohort study including women, who underwent retropubic MUS procedure for SUI between 2012 and 2019 with a follow-up of 12 months. Primary endpoint was cure of SUI assessed by the validated questionnaire International Consultation of Incontinence-Questionnaire-Urinary Incontinence-Short Form. Univariate and multivariate analyses were applied to identify risk factors for sling failure. Wilcoxon signed-rank tests were used as paired samples tests. The significance level was set at 5%.
662 women with a median age of 65 (IQR 19) were included in the investigation. 523 (79.0%) presented with complicated SUI. Cure was reported by 213 (32.2%) women. Independent predictors for failure were obesity, pharmacotherapy for overactive bladder, postoperative sling adjustment and the utilization of partially absorbable mesh (PAS). PAS correlated with a 56% decrease in the odds for achieving cure.
This investigation questions the role of partially absorbable mesh for stress urinary incontinence procedures and hereby scrutinizes the utilization of implants with inadequate clinical evidence.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2022 Jan 19 [Epub ahead of print]
Nathalie Ng-Stollmann, Christian Fünfgeld, Tanja Hüsch
Hospital Tettnang GmbH, Department of gynecology and obstetrics, Tettnang, Germany., University Medical Center of Johannes Gutenberg University, Department of Urology and Pediatric Urology, Mainz, Germany.