Multidimensional outcomes of suburethral synthetic midurethral sling removal

Nabeel A. Shakir, Connie Wang, Nirmish Singla, Feras Alhalabi, Alana Christie, Gary E. Lemack, Philippe E. Zimmern

Research output: Contribution to journalArticle

Abstract

Purpose: To report multidimensional outcomes encompassing pain, dyspareunia, and recurrent urinary tract infections (UTIs), following suburethral sling removal (SSR) of synthetic midurethral slings (MUS) placed for female stress urinary incontinence. Methods: We reviewed a prospectively maintained, IRB-approved database of women undergoing SSR at our institution. Demographic data, type of sling, and symptoms along with Urogenital Distress Inventory-Short Form (UDI-6) scores both before and after SSR were analyzed. Success was defined using several modalities including patient-reported symptoms (ideal outcome) and UDI-6 questionnaire. Results: From 3/2006–2/2017, 443 women underwent SSR of which 230 met study criteria with median overall follow-up of 23 months (mean 30 months). 180/230 (78%) patients reported 3 or more symptoms at presentation. Median most recent post-SSR total UDI-6 score was 38 vs. 50 at baseline (p < 0.0001). By UDI-6, 53% of patients achieved success post-SSR. An ideal outcome was attained in 22/230 (10%) patients. A modified outcome allowing for one minimally invasive anti-incontinence procedure and excluding sexual activity classified 112/230 (49%) patients as successes. Conclusions: While patients with MUS present with multiple symptoms, following SSR, there is sustained improvement in multiple symptom domains, including pain and urinary incontinence. Allowing for minimally invasive anti-incontinence procedures (not inclusive of subsequent suburethral sling), the rate of success was 49%, which was comparable to that derived from UDI-6 scores (53%).

Original languageEnglish (US)
JournalWorld Journal of Urology
DOIs
StateAccepted/In press - Jan 1 2019

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Suburethral Slings
Dyspareunia
Pain
Stress Urinary Incontinence
Research Ethics Committees
Urinary Incontinence
Urinary Tract Infections
Sexual Behavior
Demography
Databases

Keywords

  • Complication of sling
  • Midurethral sling
  • Outcome measure
  • Sling excision
  • UDI-6

ASJC Scopus subject areas

  • Urology

Cite this

Multidimensional outcomes of suburethral synthetic midurethral sling removal. / Shakir, Nabeel A.; Wang, Connie; Singla, Nirmish; Alhalabi, Feras; Christie, Alana; Lemack, Gary E.; Zimmern, Philippe E.

In: World Journal of Urology, 01.01.2019.

Research output: Contribution to journalArticle

Shakir, Nabeel A. ; Wang, Connie ; Singla, Nirmish ; Alhalabi, Feras ; Christie, Alana ; Lemack, Gary E. ; Zimmern, Philippe E. / Multidimensional outcomes of suburethral synthetic midurethral sling removal. In: World Journal of Urology. 2019.
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abstract = "Purpose: To report multidimensional outcomes encompassing pain, dyspareunia, and recurrent urinary tract infections (UTIs), following suburethral sling removal (SSR) of synthetic midurethral slings (MUS) placed for female stress urinary incontinence. Methods: We reviewed a prospectively maintained, IRB-approved database of women undergoing SSR at our institution. Demographic data, type of sling, and symptoms along with Urogenital Distress Inventory-Short Form (UDI-6) scores both before and after SSR were analyzed. Success was defined using several modalities including patient-reported symptoms (ideal outcome) and UDI-6 questionnaire. Results: From 3/2006–2/2017, 443 women underwent SSR of which 230 met study criteria with median overall follow-up of 23 months (mean 30 months). 180/230 (78{\%}) patients reported 3 or more symptoms at presentation. Median most recent post-SSR total UDI-6 score was 38 vs. 50 at baseline (p < 0.0001). By UDI-6, 53{\%} of patients achieved success post-SSR. An ideal outcome was attained in 22/230 (10{\%}) patients. A modified outcome allowing for one minimally invasive anti-incontinence procedure and excluding sexual activity classified 112/230 (49{\%}) patients as successes. Conclusions: While patients with MUS present with multiple symptoms, following SSR, there is sustained improvement in multiple symptom domains, including pain and urinary incontinence. Allowing for minimally invasive anti-incontinence procedures (not inclusive of subsequent suburethral sling), the rate of success was 49{\%}, which was comparable to that derived from UDI-6 scores (53{\%}).",
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