Retropubic slings are more efficient than transobturator at 10-year follow-up : a Swedish register-based study
Alexandridis, Vasileios LU
; Lundmark Drca, Anna
; Ek, Marion
; Westergren Söderberg, Marie
; Andrada Hamer, Maria
LU
and Teleman, Pia
LU
(2023)
In International Urogynecology Journal
34(6).
p.1307-1315
- Abstract
Introduction and hypothesis: Long-term performance of mid-urethral slings (MUS) and potential differences between the retropubic and the transobturator technique for insertion are scarcely studied. This study aims to evaluate the efficacy and safety 10 years after surgery and compare the two main surgical techniques used. Methods: Women who underwent surgery with a MUS between 2006 and 2010 were identified using the Swedish National Quality Register of Gynecological Surgery and were invited 10 years after the operation to answer questionnaires regarding urinary incontinence and its impact on quality-of-life parameters (UDI-6, IIQ-7) and impression of improvement, as well as questions regarding possible sling-related complications and... (More)
Introduction and hypothesis: Long-term performance of mid-urethral slings (MUS) and potential differences between the retropubic and the transobturator technique for insertion are scarcely studied. This study aims to evaluate the efficacy and safety 10 years after surgery and compare the two main surgical techniques used. Methods: Women who underwent surgery with a MUS between 2006 and 2010 were identified using the Swedish National Quality Register of Gynecological Surgery and were invited 10 years after the operation to answer questionnaires regarding urinary incontinence and its impact on quality-of-life parameters (UDI-6, IIQ-7) and impression of improvement, as well as questions regarding possible sling-related complications and reoperation. Results: The subjective cure rate reported by 2421 participating women was 63.3%. Improvement was reported by 79.2% of the participants. Women in the retropubic group reported higher cure rates, lower urgency urinary incontinence rates and lower UDI-6 scores. No difference was shown between the two methods regarding complications, reoperation due to complications or IIQ-7 scores. Persisting sling-related symptoms were reported by 17.7% of the participants, most commonly urinary retention. Mesh exposure was reported by 2.0%, reoperation because of the tape by 5.6% and repeated operation for incontinence by 6.9%, significantly more in the transobturator group (9.1% vs. 5.6%). Preoperative urinary retention was a strong predictor for impaired efficacy and safety at 10 years. Conclusions: Mid-urethral slings demonstrate good results for the treatment of stress urinary incontinence and tolerable complication profiles in a 10-year perspective. The retropubic approach displays higher efficacy than the transobturator, with no difference regarding safety.
(Less)
- author
- Alexandridis, Vasileios
LU
; Lundmark Drca, Anna
; Ek, Marion
; Westergren Söderberg, Marie
; Andrada Hamer, Maria
LU
and Teleman, Pia
LU
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Complications, Efficacy, Long-term follow-up, Mid-urethral slings, Register, Stress urinary incontinence
- in
- International Urogynecology Journal
- volume
- 34
- issue
- 6
- pages
- 1307 - 1315
- publisher
- Springer
- external identifiers
-
- pmid:36995417
- scopus:85151332380
- ISSN
- 0937-3462
- DOI
- 10.1007/s00192-023-05506-4
- project
- The use of implants in surgical treatment of urinary incontinence and pelvic organ prolapse in women
- language
- English
- LU publication?
- yes
- id
- 4b70cf49-48d5-424a-a408-d4d2d7e33c13
- date added to LUP
- 2023-05-24 13:08:19
- date last changed
- 2024-06-16 05:58:54
@article{4b70cf49-48d5-424a-a408-d4d2d7e33c13,
abstract = {{<p>Introduction and hypothesis: Long-term performance of mid-urethral slings (MUS) and potential differences between the retropubic and the transobturator technique for insertion are scarcely studied. This study aims to evaluate the efficacy and safety 10 years after surgery and compare the two main surgical techniques used. Methods: Women who underwent surgery with a MUS between 2006 and 2010 were identified using the Swedish National Quality Register of Gynecological Surgery and were invited 10 years after the operation to answer questionnaires regarding urinary incontinence and its impact on quality-of-life parameters (UDI-6, IIQ-7) and impression of improvement, as well as questions regarding possible sling-related complications and reoperation. Results: The subjective cure rate reported by 2421 participating women was 63.3%. Improvement was reported by 79.2% of the participants. Women in the retropubic group reported higher cure rates, lower urgency urinary incontinence rates and lower UDI-6 scores. No difference was shown between the two methods regarding complications, reoperation due to complications or IIQ-7 scores. Persisting sling-related symptoms were reported by 17.7% of the participants, most commonly urinary retention. Mesh exposure was reported by 2.0%, reoperation because of the tape by 5.6% and repeated operation for incontinence by 6.9%, significantly more in the transobturator group (9.1% vs. 5.6%). Preoperative urinary retention was a strong predictor for impaired efficacy and safety at 10 years. Conclusions: Mid-urethral slings demonstrate good results for the treatment of stress urinary incontinence and tolerable complication profiles in a 10-year perspective. The retropubic approach displays higher efficacy than the transobturator, with no difference regarding safety.</p>}},
author = {{Alexandridis, Vasileios and Lundmark Drca, Anna and Ek, Marion and Westergren Söderberg, Marie and Andrada Hamer, Maria and Teleman, Pia}},
issn = {{0937-3462}},
keywords = {{Complications; Efficacy; Long-term follow-up; Mid-urethral slings; Register; Stress urinary incontinence}},
language = {{eng}},
number = {{6}},
pages = {{1307--1315}},
publisher = {{Springer}},
series = {{International Urogynecology Journal}},
title = {{Retropubic slings are more efficient than transobturator at 10-year follow-up : a Swedish register-based study}},
url = {{http://dx.doi.org/10.1007/s00192-023-05506-4}},
doi = {{10.1007/s00192-023-05506-4}},
volume = {{34}},
year = {{2023}},
}