Results of sling surgery in a non-selected population

ObjectiveTo evaluate sling surgery in terms of effectiveness and quality of life, and describe the effects of confounding variables on outcomes.MethodsA retrospective cohort study using multiple validated questionnaires was conducted in a specialized pelvic floor center in the Netherlands. Women were enrolled after undergoing sling surgery between January 1, 2010, and January 31, 2012. In addition to the preoperative questionnaire, participants completed a questionnaire a minimum of 6 weeks after surgery to assess outcomes.ResultsOf 255 eligible participants, 228 (89.4%) returned the postoperative questionnaire after a mean follow-up of 14.9 months (range 2–32). At the time of follow-up, 158 (69.3%) patients considered themselves cured, and an improvement was observed in 155 (68.9%) patients; 70 (31.1%) patients rated their postoperative situation as little improved, unchanged, or deteriorated. Compared with patients who had no history of previous related surgery, patients with prior sling surgery benefited significantly less from surgery, whereas those with concomitant vaginal surgery showed similar scores in all outcome parameters. A high body mass index was found to have a negative effect on the results of surgery.Conclusionmidurethral sling surgery is both efficient and effective in curing stress urinary incontinence. However, patient characteristics and confounding variables can influence the outcome of surgery and should therefore always be discussed with the patient.