Risk factors associated with failure 1 year after retropubic or transobturator midurethral slings

Am J Obstet Gynecol. 2008 Dec;199(6):666.e1-7. doi: 10.1016/j.ajog.2008.07.050.

Abstract

Objective: The objective of the study was to identify predictors of recurrent urinary incontinence (UI) 1 year after treatment with tension-free vaginal tape (TVT) and transobturator tape (TOT).

Study design: One hundred sixty-two women with urodynamic stress urinary incontinence (SUI) were included in a clinical trial comparing TVT with TOT with at least 1 year of follow-up were included in this analysis. Potential clinical and urodynamic predictors for development of "any recurrent UI" or "recurrent SUI" 1 year after surgery were evaluated using logistic regression models.

Results: Subjects who received concurrent prolapse surgery and those taking anticholinergic medications preoperatively were more likely to develop any recurrent UI. Increasing age was independently associated with recurrent SUI. Risk factors were similar for TVT and TOT for both definitions of treatment failure.

Conclusion: Concurrent prolapse surgery and preoperative anticholinergic medication use are associated with increased risk of developing recurrent UI 1 year after TVT or TOT. Increasing age is specifically associated with the recurrence of SUI symptoms.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Analysis of Variance
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Middle Aged
  • Probability
  • Prosthesis Failure
  • Risk Factors
  • Severity of Illness Index
  • Suburethral Slings*
  • Surgical Mesh*
  • Tensile Strength
  • Time Factors
  • Treatment Failure
  • Urinary Incontinence, Stress / diagnosis
  • Urinary Incontinence, Stress / surgery*
  • Urodynamics
  • Urologic Surgical Procedures / adverse effects*
  • Urologic Surgical Procedures / instrumentation
  • Urologic Surgical Procedures / methods
  • Uterine Prolapse / diagnosis
  • Uterine Prolapse / surgery*