E-Posters-10243

10243_Buono

Pdf Summary

This study aimed to compare the subjective and objective failure rates of a secondary procedure (repeat midurethral sling (MUS) versus transurethral bulking) for recurrent stress urinary incontinence (SUI) in patients with either an intact or revised primary MUS. The study included a retrospective review of electronic medical records (EMR) from an integrated health maintenance organization (HMO) between 2007 and 2015. Patients who had at least 6 months of follow-up after the subsequent procedure were included in the final analysis.<br /><br />The results showed that patients who underwent revision of a primary MUS had comparable subjective and objective failure rates after a secondary procedure for recurrent SUI compared to patients with an intact primary MUS. There was no significant difference in the risks of subjective and objective failure rates of the secondary procedure between patients with an intact versus revised primary MUS, after adjusting for various factors such as age, urodynamic findings consistent with intrinsic sphincter deficiency (ISD), surgeon fellowship training, and whether it was the same or different surgeon for the procedures.<br /><br />The study also provided demographic and clinical information of the included patients, such as age, race, menopausal status, fellowship-trained surgeon during the primary and secondary procedures, and concurrent surgery during the primary MUS. The indication for revision of the primary MUS included mesh erosion, voiding dysfunction, incidental revision during the second procedure, refractory overactive bladder (OAB), and pelvic pain.<br /><br />Overall, the study suggests that the failure rate of a secondary procedure for recurrent SUI following a failed midurethral sling is not affected by alteration of the primary sling. This information can be valuable for clinicians in making decisions regarding the management of patients with persistent or recurrent SUI.

Keywords

secondary procedure

repeat midurethral sling

transurethral bulking

recurrent stress urinary incontinence

subjective failure rates

objective failure rates

intact primary MUS

revised primary MUS

electronic medical records

health maintenance organization