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      Urethral bulking for recurrent stress urinary incontinence after midurethral sling failure : Salvage Bulking Therapy After MUS failure

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          Abstract

          To assess the effectiveness of a polyacrylamide hydrogel (PAHG; Bulkamid®) in treating recurrent stress urinary incontinence (SUI) following a previous midurethral sling (MUS) implant.

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          Complication rates of tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials comparing tension-free midurethral tapes to other surgical procedures and different devices.

          Stefano Cavalleri, A S Secco, Rafael Boscolo-Berto … (2008)
          To evaluate the complication rates of tension-free midurethral slings compared with other surgical treatments for stress urinary incontinence, including other tension-free midurethral slings. A systematic review of the literature using MEDLINE, EMBASE, and Web of Science was performed in January 2007. Meta-analysis was conducted by using the Review Manager software 4.2. Our search identified 33 randomized controlled trials reporting data on complication rates. Our meta-analysis showed that complication rates were similar after tension-free vaginal tape (TVT) and Burch colposuspension, with the exclusion of bladder perforation, which was more common after TVT (p=0.0001), and reoperation rate, which was significantly higher after Burch colposuspension (p=0.02). TVT and pubovaginal sling were followed by similar complication rates. With regards to the comparisons among retropubic tapes, TVT and intravaginal slingplasty had similar complication rates, whereas suprapubic arc sling (SPARC) was complicated by higher rates of voiding lower urinary tract symptoms (LUTS) (p=0.02) and reoperations (p=0.04). Comparing retropubic and transobturator tapes, the occurrence of bladder perforations (p=0.007), pelvic haematoma (p=0.03), and storage LUTS (p=0.01) was significantly less common in patients treated by transobturator tapes. Tension-free slings were followed by lower risk of reoperation compared with Burch colposuspension, whereas pubovaginal sling and tension-free midurethral slings had similar complication rates. With regards to different tension-free tapes, voiding LUTS and reoperations were more common after SPARC, whereas bladder perforations, pelvic haematoma, and storage LUTS were less common after transobturator tapes. The quality of many evaluated studies was limited.
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            A three-year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence.

            M. Rezapour, U Ulmsten, Timothy Johnson (1999)
            To study the long term results of tension-free vaginal tape, a new ambulatory surgical procedure for treatment of female stress urinary incontinence. A prospective open study using a standardised protocol for pre- and post-operative evaluation. Fifty consecutive women participated in the study. All suffered from genuine stress incontinence. The mean age was 57 years (SD 11), 42 women (84%) were multiparous, 8 (16%) nulliparous. Tension-free vaginal tape implies the implantation of a prolene tape around mid-urethra via a minimal vaginal incision. The procedure is carried out under local anaesthesia, allowing the surgeon to check intra-operatively that continence has been obtained. All the women except one could be operated on an ambulatory basis under local anaesthesia. Mean operation time was 29 minutes (range 1647). Ninety percent of the women were able to micturate spontaneously within 24 hours with insignificant residual volumes. In another 10% of the women an in-dwelling catheter had to be used temporarily. There was no need for long term postoperative catheterisation (> 14 days). Post-operative evaluation was carried out after 2 to 6, 12, 24 and 36 months. According to the protocol, 86% of the women were completely cured and another 11% were significantly improved. No signs of deterioration of the results over time were observed. No defect in healing or rejection of the tape occurred. We consider the tension-free vaginal tape operation to be a safe and effective surgical procedure for the treatment of female urinary stress incontinence. The technique can be considered as an ambulatory procedure performed under local anaesthesia, allowing the majority of the women to be discharged from the clinic the same day or the day after the procedure.
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              Repeat synthetic mid urethral sling procedure for women with recurrent stress urinary incontinence.

              Kobi Stav, Peter L Dwyer, Anna Rosamilia … (2009)
              We reported and compared the outcomes of repeat mid urethral sling with primary mid urethral sling in women with stress urinary incontinence. A total of 1,225 consecutive women with urodynamic stress incontinence underwent a synthetic mid urethral sling procedure (955 retropubic, 270 transobturator) at our institution between 1999 and 2007. Of the patients 91% (1,112) were interviewed via telephone call with a structured questionnaire and were included in the analysis. Mean +/- SD followup was 50 +/- 24 months (range 12 to 114). A comparison between repeat (77, mean age 62 +/- 12 years) and primary (1,035, mean age 60 +/- 13 years) mid urethral sling groups was performed. Repeat sling was placed without removal of the previous sling. The preoperative incidence of intrinsic sphincter deficiency was higher in patients who had a repeat mid urethral sling (31% vs 13%, p <0.001). The subjective stress incontinence cure rate was 86% and 62% in the primary and repeat group, respectively (p <0.001). The repeat retropubic approach was significantly more successful than the repeat transobturator approach (71% vs 48%, p = 0.04). The rates of sling related and general postoperative complications were similar between the primary and the repeat groups. However, de novo urgency (30% vs 14%, p <0.001) and de novo urge urinary incontinence (22% vs 5%, p <0.001) were more frequent in the repeat group compared with the primary group. A repeat synthetic mid urethral sling procedure has a significantly lower cure rate than a primary mid urethral sling procedure. The repeat retropubic approach has a higher success rate than the repeat transobturator approach. The incidence of de novo urgency and urge incontinence are significantly higher in repeat procedures.
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                Author and article information

                Journal
                Title: Neurourology and Urodynamics
                Abbreviated Title: Neurourol. Urodynam.
                Publisher: Wiley
                ISSN: 07332467
                Publication date Created: March 2017
                Publication date (Print): March 2017
                Publication date (Electronic): March 31 2016
                Volume: 36
                Issue: 3
                Pages: 722-726
                Affiliations
                [1 ]Department of Gynecology and Obstetrics; Cantonal Hospital; Frauenfeld Switzerland
                [2 ]Department of Gynecology; German Red Cross Hospital Chemnitz-Rabenstein; Chemnitz Germany
                [3 ]Coombe Women and Infants University Hospital; Dublin Ireland
                Article
                DOI: 10.1002/nau.23007
                PubMed ID: 27037856
                SO-VID: aa54a126-64f6-4e4b-b444-e95bf20ae987
                Copyright © © 2016
                License:

                http://doi.wiley.com/10.1002/tdm_license_1.1

                http://creativecommons.org/licenses/by-nc/4.0/

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