Incontinence outcomes in women undergoing primary and repeat midurethral sling procedures: Editorial comment

摘要

The only documented long-term curative treatment for stress urinary incontinence (SUI) is surgery. The midurethral sling procedure is the most common surgical procedure for SUI performed in the United States and is considered to be the criterion standard for SUI treatment. A large number of different midurethral sling procedures have been performed; success rates at 12 months after surgery range from 77% to 90%. More than 103,000 women with SUI undergo midurethral sling procedures annually in the United States; of these, an estimated 23,600 will suffer a recurrence. Despite limited data, a repeat midurethral sling procedure is the most common approach to manage recurrent SUI. Only a few small cohort and case studies have investigated outcomes of repeat midurethral sling procedures for SUI.The primary aim of this retrospective cohort study was to compare SUI and other lower urinary tract symptom outcomes among women undergoing repeat midurethral sling procedures with those undergoing primary midurethral sling procedures. Cure, the primary outcome measure, was defined as responses of' 'not at all" or' 'somewhat'' to both questions of the Urogenital Distress Inventory 6 stress subscale. Stress urinary incontinence symptoms were assessed using the Incontinence Impact Questionnaire 7. Multivariable analysis was used to control for baseline symptoms as measured by the Medical Epidemiologic and Social Aspects of Aging questionnaire urge scale score and Urogenital Distress Inventory 6 stress subscale score.