Results of repeat midurethral sling for the treatment of recurrent female stress urinary incontinence [Résultats d'une deuxième bandelette sous-urétrale dans le traitement de l'incontinence urinaire d'effort féminine persistante ou récidivante]

摘要

Objective: To evaluate the results of a second midurethral sling (MUS) implantation after immediate or late recurrence of stress urinary incontinence (SUI) in women following a first MUS implantation. Patients and methods: We performed a retrospective study of 36 patients who have had a second MUS between 2000 and 2011. All patients had preoperative urodynamic assessment using French validated scales (measurement of urinary handicap [MUH] and Ditrovie's scale) a correction of SUI by Ulmsten's test. The second tape was placed in the usual way without removal of the first one. The therapeutic results were evaluated by the presence or the absence of leaks as measured by MUH and Ditrovie's scale, and classified as "success" in the absence of leaks or the presence of small leaks without needing protection, "improvement" if significant decrease in urine leakage at subjective patient interview and "failed" in other cases. Results: The mean age of 36 patients was 64. ±. 9.6 years. Thirty patients had a tension-free vaginal tape (TVT) as second tape and six patients had a transobturator tape. At 3 months, success rate was 74.3% (. n=. 26). Six patients had partial improvement (17.1%) and three patients had no improvement (8.6%). One was lost sight. After a follow-up of 5 years, these results remained unmodified for the ten patients reviewed. Conclusion: The implantation of a second MUS was a good option for women with persistence or recurrence of SUI after a first MUS implantation.