To systematically compare success, cure and complication rates of urethral sling surgeries in stress urinary incontinence patients with and without a history of pelvic radiotherapy (RT).
We searched PUBMED, EMBASE, and Web of Science to identify relevant articles. The primary outcomes were the success and cure rates. The secondary outcomes included the rates of infection, urethral erosion, total complications, explantation, and satisfaction. Outcomes were analyzed using a random-effects model to calculate the unadjusted odds ratio (OR) in patients with a history of RT compared with those without prior RT.
On pooled analysis, we found significantly lower odds of success (odds ratio (OR) 0.68; 95% confidence interval (CI) 0.53-0.87, p<0.001) and cure (OR 0.67; 95% CI 0.55-0.82, p<0.001) in radiated patients than in non-irradiated patients. Subgroup analysis by type of sling showed significantly lower odds of success in Advance subgroup (OR 0.66; 95% CI 0.45-0.95, p<0.001) and significantly lower odds of cure in Advance (OR 0.59; 95% CI 0.36-0.95, p<0.001) and Atoms subgroups (OR 0.70; 95% CI 0.54-0.93, p<0.001). We also found significantly greater odds of sling explantation (OR 2.93; 95% CI 1.62-5.29, p<0.001) and infection (OR 3.06, 95% CI 1.03-9.07, p<0.001) in radiated patients than in non-radiated patients.
Patients with a history of pelvic RT have lower odds of success and cure and higher odds of infection and sling explantation than those without a history of pelvic radiotherapy.
Urology. 2023 Aug 03 [Epub ahead of print]
Umar Ghaffar, Behzad Abbasi, Jose Luis Guzman Fuentes, Architha Sudhakar, Nizar Hakam, Allen Smith, Charles Jones, Nathan M Shaw, Benjamin N Breyer
Department of Urology, University of California San Francisco, San Francisco, CA., Department of Urology, University of California San Francisco, San Francisco, CA; Department of Urology, MedStar Georgetown University Hospital, Washington DC; Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington DC., Department of Urology, University of California San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA. Electronic address: .