Retropubic slings are more efficient than transobturator at 10-year follow-up : a Swedish register-based study

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Alexandridis, VasileiosLund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine (author)

Retropubic slings are more efficient than transobturator at 10-year follow-up : a Swedish register-based study

Article/chapterEnglish2023

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2023-03-30
Springer Science and Business Media LLC,2023

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LIBRIS-ID:oai:lup.lub.lu.se:4b70cf49-48d5-424a-a408-d4d2d7e33c13
https://lup.lub.lu.se/record/4b70cf49-48d5-424a-a408-d4d2d7e33c13URI
https://doi.org/10.1007/s00192-023-05506-4DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:152387716URI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype

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Introduction and hypothesis: Long-term performance of mid-urethral slings (MUS) and potential differences between the retropubic and the transobturator technique for insertion are scarcely studied. This study aims to evaluate the efficacy and safety 10 years after surgery and compare the two main surgical techniques used. Methods: Women who underwent surgery with a MUS between 2006 and 2010 were identified using the Swedish National Quality Register of Gynecological Surgery and were invited 10 years after the operation to answer questionnaires regarding urinary incontinence and its impact on quality-of-life parameters (UDI-6, IIQ-7) and impression of improvement, as well as questions regarding possible sling-related complications and reoperation. Results: The subjective cure rate reported by 2421 participating women was 63.3%. Improvement was reported by 79.2% of the participants. Women in the retropubic group reported higher cure rates, lower urgency urinary incontinence rates and lower UDI-6 scores. No difference was shown between the two methods regarding complications, reoperation due to complications or IIQ-7 scores. Persisting sling-related symptoms were reported by 17.7% of the participants, most commonly urinary retention. Mesh exposure was reported by 2.0%, reoperation because of the tape by 5.6% and repeated operation for incontinence by 6.9%, significantly more in the transobturator group (9.1% vs. 5.6%). Preoperative urinary retention was a strong predictor for impaired efficacy and safety at 10 years. Conclusions: Mid-urethral slings demonstrate good results for the treatment of stress urinary incontinence and tolerable complication profiles in a 10-year perspective. The retropubic approach displays higher efficacy than the transobturator, with no difference regarding safety.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Reproduktionsmedicin och gynekologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Obstetrics, Gynaecology and Reproductive Medicine hsv//eng
Complications
Efficacy
Long-term follow-up
Mid-urethral slings
Register
Stress urinary incontinence

Added entries (persons, corporate bodies, meetings, titles ...)

Lundmark Drca, AnnaKarolinska Institute (author)
Ek, MarionKarolinska Institute (author)
Westergren Söderberg, MarieKarolinska Institutet,Karolinska Institute (author)
Andrada Hamer, MariaLund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)gyn-man (author)
Teleman, PiaLund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)gyn-pte (author)
Obstetrik och gynekologi, LundSektion V (creator_code:org_t)

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