Outcomes of Macroplastique injections for stress urinary incontinence after suburethral sling removal

Dayron Rodríguez, Timothy Carroll, Feras Alhalabi, Maude Carmel, Philippe E. Zimmern

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Introduction: To evaluate outcomes following urethral Macroplastique (MPQ) injection in women with stress urinary incontinence (SUI) following suburethral sling removal (SSR) for synthetic sling complications. Methods: Following Institutional Review Board approval, charts of non-neurogenic women with SUI after SSR who underwent MPQ injection(s) and had at least 6 months minimum follow-up were reviewed from a prospectively maintained database. Demographic data, questionnaire (Urogenital Distress Inventory-6 [UDI-6] and Quality of Life) scores, and pad usage were recorded. Patients were followed with repeat questionnaires and three-dimensional ultrasound evaluating MPQ volume. Success following MPQ was defined as a composite score of a UDI-6 question 3 score of 0 to 1 at last visit and no additional anti-incontinence therapy. Results: From 2011 to 2018, 70 women with mean age 62.7 years met study criteria. At a mean follow-up of 46.4 ± 1.5 months, the success rate after the first MPQ injection was 46%. Following a repeat MPQ injection when indicated, the overall success rate for the entire cohort was 69%. Despite the objective failure, the majority of patients reported subjective improvement (83%) and reduced pad usage (78%). On multivariate analysis: age, body mass index, previous hysterectomy, hormone replacement therapy, type of sling removed and baseline urodynamics (UDS) parameters were not predictors of MPQ failure. Higher parity was a predictor of MPQ failure (hazard ratio = 1.980; P =.032). Conclusion: MPQ injection is a durable and effective management option for SUI following SSR, although a second injection may be required to achieve the desired success.

Original languageEnglish (US)
Pages (from-to)994-1001
Number of pages8
JournalNeurourology and urodynamics
Volume39
Issue number3
DOIs
StatePublished - Mar 1 2020

Keywords

  • bulking agent
  • intrinsic sphincter deficiency
  • Macroplastique
  • sling removal
  • stress urinary incontinence

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology

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