Predictive value of urodynamics on outcome after midurethral sling surgery for female stress urinary incontinence

Objective The aim of this study was to evaluate the value of urodynamic investigation in the preoperative workup of midurethral sling surgery and to identify risk factors for failure after 3 different midurethral sling procedures. Study Design Retrospective cohort study. 437 women who underwent a te...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2009-06, Vol.200 (6), p.649.e1-649.e12
Main Authors: Houwert, R. Marijn, MD, Venema, Pieter L., MD, PhD, Aquarius, Annelies E., PhD, Bruinse, Hein W., MD, PhD, Kil, Paul J.M., MD, PhD, Vervest, Harry A.M., MD, PhD
Format: Article
Language:English
Subjects:
Biological and medical sciences
Female
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
Middle Aged
Monarc
Nephrology. Urinary tract diseases
Obstetrics and Gynecology
predictive value
Predictive Value of Tests
Retrospective Studies
stress urinary incontinence
Suburethral Slings
tension-free vaginal tape
tension-free vaginal tape-obturator
Treatment Outcome
Urinary Incontinence, Stress - physiopathology
Urinary Incontinence, Stress - surgery
Urinary system involvement in other diseases. Miscellaneous
Urinary tract. Prostate gland
urodynamic investigation
Urodynamics
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Summary:Objective The aim of this study was to evaluate the value of urodynamic investigation in the preoperative workup of midurethral sling surgery and to identify risk factors for failure after 3 different midurethral sling procedures. Study Design Retrospective cohort study. 437 women who underwent a tension-free vaginal tape, Monarc, or tension-free vaginal tape-obturator procedure without other simultaneously performed urogynecological surgery were included. Preoperative data were collected from the medical files. Patients who reported any amount of leakage were considered failures. The mean follow-up of the study population was 14 months. Results After multivariate analysis, mixed urinary incontinence ( P = .04), previous incontinence surgery ( P = .022), and detrusor overactivity ( P = .02) were significantly related to failure of midurethral sling procedures. There were no predictive urodynamic parameters for failure in patients with mixed urinary incontinence or previous incontinence surgery. Conclusion The standard use of urodynamic investigation in the preoperative workup of midurethral sling surgery needs to be revisited.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2008.12.039