Long-term functional results after unilateral mid-urethral sling transection for voiding dysfunction

• Published in: European journal of obstetrics & gynecology and reproductive biology 2016-12, Vol.207, p.89-93
• Main Authors: Baekelandt, F, Van Oyen, P, Ghysel, C, Van der Aa, F, Ampe, J
• Format: Article
• Language: English
• Subjects: Belgium - epidemiology; Cohort Studies; Dyspareunia - epidemiology; Dyspareunia - etiology; Dyspareunia - physiopathology; Dyspareunia - prevention & control; Electronic Health Records; Female; Follow-Up Studies; Humans; Middle Aged; Obstetrics and Gynecology; Patient Satisfaction; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - physiopathology; Postoperative Complications - prevention & control; Recurrence; Retrospective Studies; Risk; Secondary Prevention; Sling transection; Stress urinary incontinence; Suburethral Slings - adverse effects; Synthetic mid-urethral sling; Urge urinary incontinence; Urgency; Urinary Incontinence, Stress - epidemiology; Urinary Incontinence, Stress - physiopathology; Urinary Incontinence, Stress - prevention & control; Urinary Incontinence, Stress - surgery; Urinary Incontinence, Urge - epidemiology; Urinary Incontinence, Urge - etiology; Urinary Incontinence, Urge - physiopathology; Urinary Incontinence, Urge - prevention & control; Urinary Retention - epidemiology; Urinary Retention - etiology; Urinary Retention - physiopathology; Urinary Retention - prevention & control; Urinary Tract Infections - epidemiology; Urinary Tract Infections - etiology; Urinary Tract Infections - physiopathology; Urinary Tract Infections - prevention & control; Urodynamics
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2016.10.020

Abstract Objective To investigate the long-term outcomes of unilateral mid-urethral sling transection to treat voiding dysfunction after synthetic mid-urethral sling placement for stress urinary incontinence. Study design Twenty-three patients who underwent an unilateral sling transection were analyzed retrospectively. Patient records were analyzed for subjective outcome, and pre- and postoperative flow patterns were used as objective outcome parameters. Results At the first postoperative follow-up, 77.3% of the patients remained dry. After a mean follow-up of 42 months, 73.9% of patients were continent. The flow pattern after lateral sling transection was significantly better than pre-operatively, with higher maximum flow rate (24.2 ml/s, p = 0.001), higher mean flow rate (10.4 ml/s, p = 0.001), higher voided volume (308.5 ml, p = 0.002) and lower residual volume (28.7 ml, p = 0.003). At final postoperative follow-up, eight patients (34.8%) reported urgency and six patients (26.1%) were incontinent; four of these patients (17.4%) mainly had urge incontinence. Conclusions Unilateral mid-urethral sling transection is a safe, effective technique to treat voiding symptoms with good preservation of continence. The technique repairs the obstructive flow effectively. Urgency and urge incontinence after mid-urethral sling placement are difficult to treat with transection alone.