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Multicenter Study
. 2022 Apr 1;28(4):194-200.
doi: 10.1097/SPV.0000000000001092. Epub 2021 Sep 22.

Success of Concomitant Versus Interval Slings for Prevention and Treatment of Bothersome de Novo Stress Urinary Incontinence

Jocelyn J Fitzgerald  1 , Alex Soriano  2 , Joseph Panza  3 , Tanya P Hoke  4 , Shweta P Desai  5 , Amanda M Artsen  6 , Sarah E Andiman  7 , Danielle D Antosh  5 , Robert E Gutman  1
Affiliations
Multicenter Study

Success of Concomitant Versus Interval Slings for Prevention and Treatment of Bothersome de Novo Stress Urinary Incontinence

Jocelyn J Fitzgerald et al. Female Pelvic Med Reconstr Surg. .

Abstract

Background: Despite large trials designed to guide management on whether to perform a prophylactic continence procedure at the time of pelvic organ prolapse (POP) repair, it remains unclear if a staged or interval approach confers advantages in treatment of bothersome stress urinary incontinence (SUI) in women without bothersome SUI before their POP repair.

Objective: The objective of this study was to compare success of concomitant versus interval slings for the prevention/treatment of de novo bothersome SUI after POP repair.

Study design: This multicenter retrospective cohort with prospective follow-up enrolled women with minimal or no SUI symptoms who underwent minimally invasive apical surgery for stage 2 or higher POP between 2011 and 2018 and had a concomitant sling placed at the time of POP surgery or an interval sling placed. Prospectively, all patients were administered the Urogenital Distress Inventory Short-Form 6, the Patient Global Impression of Improvement, and questions on reoperation/retreatment and complications.

Results: A total of 120 patients had concomitant slings, and 60 had interval slings. There were no differences in the proportion of patients who had intrinsic sphincter deficiency (22% vs 20%), although the concomitant sling group was more likely to have a positive cough stress test result (30% vs 8%, P = 0.006). The interval sling group was more likely to report "yes" to SUI symptoms on Urogenital Distress Inventory Short-Form 6 (3% vs 30%, P = 0.0006) and during their postoperative visit (0% vs 24%, P < 0.0001). There were no differences in surgical complications.

Conclusions: Among women with minimal or no SUI symptoms undergoing prolapse repair, concomitant slings resulted in lower rates of bothersome SUI compared with similar women undergoing interval sling placement.

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Conflict of interest statement

The authors have declared they have no conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
Study design. POP, pelvic organ prolapse; PVR, postvoid residual volume; SUI, stress urinary incontinence.
See this image and copyright information in PMC

References

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