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Symptom Resolution and Recurrent Urinary Incontinence Following Removal of Painful Midurethral Slings
- Source :
- Urology. 159:78-82
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Objective To evaluate pain improvement and recurrent stress incontinence (SUI) following painful synthetic midurethral sling (MUS) removal. Methods We conducted a retrospective review of patients who underwent synthetic MUS removal at our institution from 2009–2016 for the indication of pain. We recorded sling type (transobturator vs retropubic), complete vs partial removal, and presenting symptoms. Postoperative pain improvement was categorized as resolved (pain resolved, requiring no further therapy), improved (pain less bothersome, may require further therapy), or unresolved (no/minimal improvement, requiring further management). Recurrent incontinence and further reconstructive procedures were assessed. Results 87 patients (49 complete and 38 partial removal) with pain as the primary indication for removal were included. Median age at intervention was 54 years with median follow-up of 8 months. Overall, pain improved or resolved in 78.1% of cases. Complete removal was associated with significantly greater percentage of pain resolution (63.3%) compared to partial removal (26.3%) (P = 0.002) regardless of sling type. No significant differences in recurrent SUI were noted in complete vs partial removal. Additional reconstructive procedures were performed in 28 patients, most commonly sling placement, with no significant difference in complete (20.4%) vs partial (28.9%) removal groups (P = 0.36). The overall complication rate was low (5.7%), a majority of which were transfusions (4.6%). Conclusion Following MUS removal, most patients experienced resolution or improvement of pain. Complete sling removal was associated with significantly greater percentage of pain resolution compared to partial removal in both retropubic and transobturator slings. Rates of recurrent SUI and reintervention for SUI were not related to the extent of sling removal.
- Subjects :
- Reoperation
Stress incontinence
medicine.medical_specialty
Urinary Incontinence, Stress
Urology
Postoperative pain
Urinary incontinence
Sling (weapon)
Recurrence
medicine
Humans
Device Removal
Midurethral Slings
Pain, Postoperative
Suburethral Slings
Retrospective review
Sling removal
business.industry
Significant difference
Middle Aged
medicine.disease
Surgery
Treatment Outcome
Urinary Incontinence
Urologic Surgical Procedures
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 00904295
- Volume :
- 159
- Database :
- OpenAIRE
- Journal :
- Urology
- Accession number :
- edsair.doi.dedup.....0810d315ee18d34e20b930c02dde5f6c