Management of recurrent stress urinary incontinence after burch and sling procedures

Aims To examine treatment options selected for recurrent stress urinary incontinence (rSUI) in follow‐up after Burch, autologous fascial and synthetic midurethral sling (MUS) procedures. Methods We performed a secondary analysis of the SISTER and ToMUS trials of participants who underwent primary st...

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Bibliographic Details
Published in:Neurourology and urodynamics 2016-03, Vol.35 (3), p.344-348
Main Authors: Zimmern, Philippe E., Gormley, E.Ann, Stoddard, Anne M., Lukacz, Emily S., Sirls, Larry, Brubaker, Linda, Norton, Peggy, Oliphant, Sallie S., Wilson, Tracey
Format: Article
Language:English
Subjects:
Adult
Autografts
Disease-Free Survival
Fascia - transplantation
Female
Humans
Kaplan-Meier Estimate
Middle Aged
Prosthesis Design
Randomized Controlled Trials as Topic
Recurrence
recurrent stress urinary incontinence
Reoperation
Risk Factors
Suburethral Slings
surgical treatment
Time Factors
Treatment Outcome
Urinary Incontinence, Stress - diagnosis
Urinary Incontinence, Stress - physiopathology
Urinary Incontinence, Stress - surgery
Urologic Surgical Procedures - adverse effects
Urologic Surgical Procedures - instrumentation
Urologic Surgical Procedures - methods
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Summary:Aims To examine treatment options selected for recurrent stress urinary incontinence (rSUI) in follow‐up after Burch, autologous fascial and synthetic midurethral sling (MUS) procedures. Methods We performed a secondary analysis of the SISTER and ToMUS trials of participants who underwent primary stress urinary incontinence (SUI) treatment (without prior SUI surgery or concomitant procedures). Using Kaplan–Meier analysis, retreatment‐free survival rates by initial surgical procedure were compared. Mean MESA (Medical Epidemiologic and Social Aspects of Aging) stress index was also compared between those retreated for rSUI compared to those not retreated. Results Half of the women in the SISTEr trial met inclusion criteria for this analysis (329/655, 174 Burch and 155 fascial sling), as did 444/597 (74%) of subjects in ToMUS (221 transobturator midurethral sling (TMUS), and 223 retropubic midurethral sling (RMUS). Types of surgical retreatment included autologous fascial sling (19), synthetic sling (1), and bulking agent (18). Five‐year retreatment free survival rates (and standard errors) were 87% (3%), 96% (2%), 97% (1%), and 99% (0.7%) for Burch, autologous fascial sling, TMUS, and RMUS groups respectively (P 
ISSN:0733-2467
1520-6777
DOI:10.1002/nau.22714