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Effect of lower urinary tract conditions on surgical outcomes of different suburethral sling procedures for female stress urinary incontinence

  • Urology – Original Paper
  • Published:
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Abstract

Purpose

The suburethral sling procedure has been widely used as the first-line treatment for female stress urinary incontinence (SUI). This study retrospectively compared the long-term surgical outcomes and complications between retropubic and transobturator suburethral sling procedures.

Methods

From 2010 to 2022, a total of 533 women with SUI underwent retropubic pubovaginal sling (PVS) or transobturator tape (TOT) procedures using a synthetic polypropylene mesh with or without concomitant anterior colporrhaphy. All patients underwent preoperative videourodynamic studies, Valsalva leak point pressure (VLPP), and voiding efficiency (VE). The success rate, postoperative complications, overactive bladder symptoms, transvaginal urethrolysis, and repeat procedures were compared among different surgical procedures.

Results

Among the patients, PVS was performed in 251 (47.1%) patients and with colporrhaphy in 58 (10.9%), TOT in 174 (32.6%) and with colporrhaphy in 50 (9.4%). The success rate was 87.4% in the PVS group and 75.4% in the TOT group, with or without colporrhaphy (p = 0.001). Urethrolysis was performed in 4.7% of the patients, and repeat suburethral sling procedures were performed in 8.3%. The overall success rate was significantly lower in TOT group, either with high or low VLPP, or with high or low VE. The rate of persistent OAB was significantly higher in TOT group regardless of VLPP or VE, whereas patients with VE < 90% at baseline had a significantly higher rate of postoperative dysuria.

Conclusion

TOT procedures had an inferior long-term success rate than PVS procedures for female SUI. Additionally, no differences in the success rate were observed between patients with different bladder functions, high or low VLPP, and high or low VE.

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Data availability

The data of this study can be obtained after contacting the corresponmding authors aftert approval of the IRB of the institution.

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Funding

This study was supported by the grant from Tzu Chi Medical Foundation, grant number TCMF-MP 110-03-01 and TCMF-SP 112-01.

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Authors and Affiliations

  1. Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 707, Section 3, Chung-Yang Road, Hualien, Taiwan

    Yuan-Hong Jiang, Sheng-Fu Chen & Hann-Chorng Kuo

  2. Tzu Chi University, Hualien, Taiwan

    Yuan-Hong Jiang, Sheng-Fu Chen & Hann-Chorng Kuo

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  1. Yuan-Hong Jiang
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  2. Sheng-Fu Chen
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Contributions

Yuan-Hong Jiang and Shenf-Fu Chen collect data and investigations Yuan-Hong Jiang wrote the draft manuscript Hann-Chorng Kuo supervised the study and revised the manuscript

Corresponding author

Correspondence to Hann-Chorng Kuo.

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The authors declare no competing interests.

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Jiang, YH., Chen, SF. & Kuo, HC. Effect of lower urinary tract conditions on surgical outcomes of different suburethral sling procedures for female stress urinary incontinence. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-04047-z

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