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

• 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
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2008.12.039

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.