Article ID Journal Published Year Pages File Type
3920468 European Journal of Obstetrics & Gynecology and Reproductive Biology 2012 4 Pages PDF
Abstract

ObjectiveTo determine the functional outcomes after synthetic sling revision surgery performed for voiding dysfunction.Study designA retrospective review of 63 women who underwent surgical revision of a synthetic sling (SS) over an 11 year period between 2000 and 2010 inclusive, for the treatment of voiding dysfunction. Voiding dysfunction was defined as a persistently raised post-void residual of >150 ml. Patient review included demographics, a comprehensive medical history, all surgical reports and a detailed proforma with details of lower urinary tract symptoms, physical findings and bladder diaries. Variables were compared between methods of sling revision using the Fisher exact test (Freeman–Halton extension) with a 2 by 3 contingency table. Statistical significance is defined as P ≤ 0.05.ResultsSixty-three women underwent SS revision for voiding dysfunction with an overall success rate of 87%. Three types of surgical revision were performed; simple SS division (46/63, 73%), partial excision of SS material (13/63, 21%) and either division or excision but with a concomitant procedure to prevent recurrent SUI (4/63, 6%). Persistent voiding dysfunction following revision in each of the three groups was 5/46 (10.9%), 1/13 (7.7%) and 2/4 (50%) respectively (P = 0.09). Subsequent surgery for recurrent SUI in each of the groups was 1/46 (2.2%), 3/13 (23.1%) and 0/4 (0%) respectively (P = 0.04).ConclusionsSurgical revision of a SS is an effective treatment for postoperative voiding dysfunction. Both simple division and partial excision of the SS are successful, but simple division carries a lower risk of recurrent SUI. A concomitant SUI procedure at the time of revision may prevent recurrence but may increase the risk of persistent voiding dysfunction.

Related Topics
Health Sciences Medicine and Dentistry Obstetrics, Gynecology and Women's Health
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