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Risk factors of treatment failure of midurethral sling procedures for women with urinary stress incontinence

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Abstract

Introduction and hypothesis

Midurethral sling (MUS) is now the first line surgical treatment for female stress urinary incontinence. Our aim was to identify predictors for MUS failure.

Methods

A total of 1,225 consecutive women with urodynamic urinary stress incontinence had a synthetic MUS (955 retropubic and 270 transobturator) at our institution between 1999 and 2007. Multivariate analysis was performed in order to identify independent risk factors for failure.

Results and conclusions

At a mean follow-up of 50 ± 24 months (range, 12–114), the subjective cure rate was 84.7%. Multivariate analysis revealed that BMI >25 (OR, 2.9), mixed incontinence (OR, 2.4), previous continence surgery (OR, 2.2), intrinsic sphincter deficiency (OR, 1.9), and diabetes mellitus (OR, 1.8) are significant independent predictors for MUS failure. Concomitant prolapse surgery decreased the likelihood of surgical failure after MUS (OR, 0.6). Patient’s age and the type of the sling were not found to be risk factors for surgical failure.

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Authors and Affiliations

  1. Department of Urogynaecology, Mercy Hospital for Women, University of Melbourne, Melbourne, Victoria, Australia

    Kobi Stav, Peter L. Dwyer, Anna Rosamilia, Lore Schierlitz, Yik N. Lim & Joseph Lee

  2. Department of Urogynaecology, Monash Medical Centre, Monash University, Melbourne, Victoria, Australia

    Anna Rosamilia & Yik N. Lim

  3. Urogynaecology Department, Mercy Hospital for Women, 163 Studley Road, Heidelberg, Victoria, 3084, Australia

    Kobi Stav

Authors
  1. Kobi Stav
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  2. Peter L. Dwyer
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  3. Anna Rosamilia
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  4. Lore Schierlitz
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  5. Yik N. Lim
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  6. Joseph Lee
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Corresponding author

Correspondence to Kobi Stav.

Appendix

Appendix

Table 3 Follow-up questionnaire
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Stav, K., Dwyer, P.L., Rosamilia, A. et al. Risk factors of treatment failure of midurethral sling procedures for women with urinary stress incontinence. Int Urogynecol J 21, 149–155 (2010). https://doi.org/10.1007/s00192-009-1020-9

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  • DOI: https://doi.org/10.1007/s00192-009-1020-9

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