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Dyspareunia and pelvic pain: comparison of mid-urethral sling methods 10 years after insertion

Lundmark Drca, Anna ; Alexandridis, Vasileios LU orcid ; Andrada Hamer, Maria LU ; Teleman, Pia LU ; Westergren Söderberg, Marie and Ek, Marion (2023) In International Urogynecology Journal
Abstract
Introduction and hypothesis
The mid-urethral sling (MUS) has been used for more than 30 years to cure stress urinary incontinence. The objective of this study was to assess whether surgical technique affects the outcome after more than ten years, regarding dyspareunia and pelvic pain.
Methods
In this longitudinal cohort study we used the Swedish National Quality Register of Gynecological Surgery to identify women who underwent MUS surgery in the period 2006–2010. Out of 4348 eligible women, 2555 (59%) responded to the questionnaire sent out in 2020–2021. The two main surgical techniques, the retropubic and the obturatoric approach, were represented by 1562 and 859 women respectively. The Urogenital Distress Inventory-6 (UDI-6)... (More)
Introduction and hypothesis
The mid-urethral sling (MUS) has been used for more than 30 years to cure stress urinary incontinence. The objective of this study was to assess whether surgical technique affects the outcome after more than ten years, regarding dyspareunia and pelvic pain.
Methods
In this longitudinal cohort study we used the Swedish National Quality Register of Gynecological Surgery to identify women who underwent MUS surgery in the period 2006–2010. Out of 4348 eligible women, 2555 (59%) responded to the questionnaire sent out in 2020–2021. The two main surgical techniques, the retropubic and the obturatoric approach, were represented by 1562 and 859 women respectively. The Urogenital Distress Inventory-6 (UDI-6) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), as well as general questions concerning the MUS surgery, were sent out to the study population. Dyspareunia and pelvic pain were defined as primary outcomes. Secondary outcomes included PISQ-12, general satisfaction, and self-reported problems due to sling insertion.
Results
A total of 2421 women were included in the analysis. Among these, 71% responded to questions regarding dyspareunia and 77% responded to questions regarding pelvic pain. In a multivariate logistic regression analysis of the primary outcomes, we found no difference in reported dyspareunia (15% vs 17%, odds ratio (OR) 1.1, 95% CI 0.8–1.5) or in reported pelvic pain (17% vs 18%, OR 1.0, 95% CI 0.8–1.3) between the retropubic and obturatoric techniques among study responders.
Conclusion
Dyspareunia and pelvic pain 10–14 years after insertion of a MUS do not differ with respect to surgical technique. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Dyspareunia, Suburethral Slings, pelvic pain, Sexual dysfunction, Stress urinary incontinence
in
International Urogynecology Journal
publisher
Springer
external identifiers
  • scopus:85164342599
  • pmid:37428179
ISSN
1433-3023
DOI
10.1007/s00192-023-05585-3
project
The use of implants in surgical treatment of urinary incontinence and pelvic organ prolapse in women
language
English
LU publication?
yes
id
6374f48c-b547-423d-9a47-f2ee4b56d52b
date added to LUP
2023-09-11 21:28:29
date last changed
2024-02-20 01:03:18
@article{6374f48c-b547-423d-9a47-f2ee4b56d52b,
  abstract     = {{Introduction and hypothesis<br/>The mid-urethral sling (MUS) has been used for more than 30 years to cure stress urinary incontinence. The objective of this study was to assess whether surgical technique affects the outcome after more than ten years, regarding dyspareunia and pelvic pain.<br/>Methods<br/>In this longitudinal cohort study we used the Swedish National Quality Register of Gynecological Surgery to identify women who underwent MUS surgery in the period 2006–2010. Out of 4348 eligible women, 2555 (59%) responded to the questionnaire sent out in 2020–2021. The two main surgical techniques, the retropubic and the obturatoric approach, were represented by 1562 and 859 women respectively. The Urogenital Distress Inventory-6 (UDI-6) and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), as well as general questions concerning the MUS surgery, were sent out to the study population. Dyspareunia and pelvic pain were defined as primary outcomes. Secondary outcomes included PISQ-12, general satisfaction, and self-reported problems due to sling insertion.<br/>Results<br/>A total of 2421 women were included in the analysis. Among these, 71% responded to questions regarding dyspareunia and 77% responded to questions regarding pelvic pain. In a multivariate logistic regression analysis of the primary outcomes, we found no difference in reported dyspareunia (15% vs 17%, odds ratio (OR) 1.1, 95% CI 0.8–1.5) or in reported pelvic pain (17% vs 18%, OR 1.0, 95% CI 0.8–1.3) between the retropubic and obturatoric techniques among study responders.<br/>Conclusion<br/>Dyspareunia and pelvic pain 10–14 years after insertion of a MUS do not differ with respect to surgical technique.}},
  author       = {{Lundmark Drca, Anna and Alexandridis, Vasileios and Andrada Hamer, Maria and Teleman, Pia and Westergren Söderberg, Marie and Ek, Marion}},
  issn         = {{1433-3023}},
  keywords     = {{Dyspareunia; Suburethral Slings; pelvic pain; Sexual dysfunction; Stress urinary incontinence}},
  language     = {{eng}},
  month        = {{07}},
  publisher    = {{Springer}},
  series       = {{International Urogynecology Journal}},
  title        = {{Dyspareunia and pelvic pain: comparison of mid-urethral sling methods 10 years after insertion}},
  url          = {{http://dx.doi.org/10.1007/s00192-023-05585-3}},
  doi          = {{10.1007/s00192-023-05585-3}},
  year         = {{2023}},
}