The impact of partially absorbable midurethral slings in stress urinary incontinence surgery : a cohort study
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Abstract
Objective
To evaluate the performance of retropubic midurethral slings (MUS) for the treatment of female stress urinary incontinence (SUI) at a certified continence center and to identify risk factors for sling failure.
Methods
This was a single-center cohort study including women who underwent a retropubic MUS procedure for SUI between 2012 and 2019 with a follow up of 12 months. Primary end point was cure of SUI assessed using the validated questionnaire International Consultation of Incontinence Questionnaire—Urinary Incontinence—Short Form. Univariate and multivariate analyses were applied to identify risk factors for sling failure. Wilcoxon signed-rank tests were used as paired samples tests. The significance level was set at 5%.
Results
A total of 662 women with a median age of 65 years (interquartile range 19 years) were included in the investigation; 523 (79.0%) presented with complicated SUI. Cure was reported by 213 (32.2%) women. Independent predictors for failure were obesity, pharmacotherapy for overactive bladder, postoperative sling adjustment, and use of partially absorbable mesh, which was correlated with a 56% decrease in the odds for achieving cure.
Conclusion
This investigation questions the role of partially absorbable mesh for stress urinary incontinence procedures and scrutinizes the use of implants with inadequate clinical evidence.
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International journal of gynecology & obstetrics, 158, 3, Wiley, Hoboken, NJ, 2022, https://doi.org/10.1002/ijgo.14095