Management of recurrent stress urinary incontinence after burch and sling procedures

Philippe E. Zimmern, E. Ann Gormley, Anne M. Stoddard, Emily S. Lukacz, Larry Sirls, Linda Brubaker, Peggy Norton, Sallie S. Oliphant, Tracey Wilson

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

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 <0.0001). For all index surgery groups, the mean MESA stress index at last visit prior to retreatment for those retreated (n = 23) was significantly higher than mean MESA stress index at last visit for those not retreated (n = 645) (P <0.0001). Conclusion In these cohorts, 6% of women after standard anti-incontinence procedures were retreated within 5 years, mostly with injection therapy or autologous fascial sling. Not all women with rSUI chose surgical retreatment.

Original languageEnglish (US)
Pages (from-to)344-348
Number of pages5
JournalNeurourology and Urodynamics
Volume35
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

Suburethral Slings
Retreatment
Stress Urinary Incontinence
Survival Rate
Kaplan-Meier Estimate
Therapeutics
Injections

Keywords

  • female
  • recurrent stress urinary incontinence
  • surgical treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology

Cite this

Zimmern, P. E., Gormley, E. A., Stoddard, A. M., Lukacz, E. S., Sirls, L., Brubaker, L., ... Wilson, T. (2016). Management of recurrent stress urinary incontinence after burch and sling procedures. Neurourology and Urodynamics, 35(3), 344-348. https://doi.org/10.1002/nau.22714

Management of recurrent stress urinary incontinence after burch and sling procedures. / Zimmern, Philippe E.; Gormley, E. Ann; Stoddard, Anne M.; Lukacz, Emily S.; Sirls, Larry; Brubaker, Linda; Norton, Peggy; Oliphant, Sallie S.; Wilson, Tracey.

In: Neurourology and Urodynamics, Vol. 35, No. 3, 01.03.2016, p. 344-348.

Research output: Contribution to journalArticle

Zimmern, PE, Gormley, EA, Stoddard, AM, Lukacz, ES, Sirls, L, Brubaker, L, Norton, P, Oliphant, SS & Wilson, T 2016, 'Management of recurrent stress urinary incontinence after burch and sling procedures', Neurourology and Urodynamics, vol. 35, no. 3, pp. 344-348. https://doi.org/10.1002/nau.22714
Zimmern, Philippe E. ; Gormley, E. Ann ; Stoddard, Anne M. ; Lukacz, Emily S. ; Sirls, Larry ; Brubaker, Linda ; Norton, Peggy ; Oliphant, Sallie S. ; Wilson, Tracey. / Management of recurrent stress urinary incontinence after burch and sling procedures. In: Neurourology and Urodynamics. 2016 ; Vol. 35, No. 3. pp. 344-348.
@article{eaa68185e0e64e43aa9ff20e7fab4002,
title = "Management of recurrent stress urinary incontinence after burch and sling procedures",
abstract = "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 <0.0001). For all index surgery groups, the mean MESA stress index at last visit prior to retreatment for those retreated (n = 23) was significantly higher than mean MESA stress index at last visit for those not retreated (n = 645) (P <0.0001). Conclusion In these cohorts, 6{\%} of women after standard anti-incontinence procedures were retreated within 5 years, mostly with injection therapy or autologous fascial sling. Not all women with rSUI chose surgical retreatment.",
keywords = "female, recurrent stress urinary incontinence, surgical treatment",
author = "Zimmern, {Philippe E.} and Gormley, {E. Ann} and Stoddard, {Anne M.} and Lukacz, {Emily S.} and Larry Sirls and Linda Brubaker and Peggy Norton and Oliphant, {Sallie S.} and Tracey Wilson",
year = "2016",
month = "3",
day = "1",
doi = "10.1002/nau.22714",
language = "English (US)",
volume = "35",
pages = "344--348",
journal = "Neurourology and Urodynamics",
issn = "0733-2467",
publisher = "Wiley-Liss Inc.",
number = "3",

}

TY - JOUR

T1 - Management of recurrent stress urinary incontinence after burch and sling procedures

AU - Zimmern, Philippe E.

AU - Gormley, E. Ann

AU - Stoddard, Anne M.

AU - Lukacz, Emily S.

AU - Sirls, Larry

AU - Brubaker, Linda

AU - Norton, Peggy

AU - Oliphant, Sallie S.

AU - Wilson, Tracey

PY - 2016/3/1

Y1 - 2016/3/1

N2 - 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 <0.0001). For all index surgery groups, the mean MESA stress index at last visit prior to retreatment for those retreated (n = 23) was significantly higher than mean MESA stress index at last visit for those not retreated (n = 645) (P <0.0001). Conclusion In these cohorts, 6% of women after standard anti-incontinence procedures were retreated within 5 years, mostly with injection therapy or autologous fascial sling. Not all women with rSUI chose surgical retreatment.

AB - 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 <0.0001). For all index surgery groups, the mean MESA stress index at last visit prior to retreatment for those retreated (n = 23) was significantly higher than mean MESA stress index at last visit for those not retreated (n = 645) (P <0.0001). Conclusion In these cohorts, 6% of women after standard anti-incontinence procedures were retreated within 5 years, mostly with injection therapy or autologous fascial sling. Not all women with rSUI chose surgical retreatment.

KW - female

KW - recurrent stress urinary incontinence

KW - surgical treatment

UR - http://www.scopus.com/inward/record.url?scp=84960408367&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84960408367&partnerID=8YFLogxK

U2 - 10.1002/nau.22714

DO - 10.1002/nau.22714

M3 - Article

C2 - 25598512

AN - SCOPUS:84960408367

VL - 35

SP - 344

EP - 348

JO - Neurourology and Urodynamics

JF - Neurourology and Urodynamics

SN - 0733-2467

IS - 3

ER -