The objective was to determine if mid-urethral sling (MUS) tensioning with a Mayo Scissor as a sub-urethral spacer compared with a Babcock clamp holding a loop of tape under the urethra results in differences in patient-reported outcomes and rates of repeat surgery over a 5-year follow-up.
Follow-up 5 years after a randomized clinical trial, utilizing primary data collection linked to administrative health data, was carried out to create a longitudinal cohort. The primary outcome was participant-reported bothersome SUI symptoms, as defined by the Urogenital Distress Inventory (UDI-6) questionnaire. Secondary outcomes included participant-reported bothersome overactive bladder (OAB) scores, median scores of three validated urinary symptom questionnaires, and rates of subsequent surgery determined through patient report and administrative data.
Two hundred and sixty (81.8%) of the original study participants provided participant-reported data at 5 years. Administrative data linkage was completed for all of the original participants (n = 318). Demographic characteristics remained similar in the two groups at the 5-year follow-up mark. No differences existed in the primary outcome of reported bothersome SUI symptoms (30.8% Scissors vs 26.8% Babcock, p = 0.559), proportion of participants with bothersome OAB, the median scores of three validated bladder questionnaires, or in rates and cumulative incidence of recurrent MUS surgery or surgical revision of mesh-related complications.
Both the Scissor and Babcock tensioning techniques provided comparable outcomes at 5 years post-MUS surgery. The information from this study allows surgeons to better decide which technique to adopt in their practice, providing confidence in longer-term cure and safety.
International urogynecology journal. 2024 Oct 01 [Epub ahead of print]
Erin A Brennand, Julia Chai, Shannon Cummings, Beili Huang, Taylor Hughes, Allison Edwards, Alison Carter Ramirez, Calgary Women’s Pelvic Health Research Group
Department of Obstetrics & Gynecology, University of Calgary, North Tower, Foothills Medical Center, 1441 - 29 Street NW, Calgary, AB, T2N 4J8, Canada. ., Department of Obstetrics & Gynecology, University of Calgary, North Tower, Foothills Medical Center, 1441 - 29 Street NW, Calgary, AB, T2N 4J8, Canada., Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Canada.