Detrusor overactivity and urge urinary incontinence [corrected] following midurethral versus bladder sling procedures.
OBJECTIVE
The objective of the study was to compare detrusor overactivity and urge urinary incontinence rates after midurethral slings versus bladder neck slings.


METHODS
Three hundred forty subjects underwent midurethral slings or bladder neck slings. Comparisons were made using Student's t test and chi2 test. Multivariate analysis was performed to detect confounding factors.


RESULTS
More patients in the midurethral sling group resolved detrusor overactivity than in the bladder neck sling group (38% versus 15%, P < .001). In addition, subjects in the midurethral sling group had significantly lower rates of de novo detrusor overactivity than subjects in the bladder neck sling group (29% versus 62%, P = .002). The only significant predictors of postoperative detrusor overactivity were preoperative detrusor overactivity (P < .001) and sling type (P < .001). After adjusting for preoperative detrusor overactivity, bladder neck slings significantly increased the risk for persistent detrusor overactivity (odds ratio 3.9).


CONCLUSIONS
Midurethral slings have increased rates of resolution of detrusor overactivity and lower rates of de novo detrusor overactivity than transvaginal bladder neck sling procedures.
Botros
Sylvia M
SM
Evanston Continence Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. sbotros@enh.org
Abramov
Yoram
Y
Goldberg
Roger P
RP
Beaumont
Jennifer L
JL
Gandhi
Sanjay
S
Miller
Jay-James R
JJ
Sand
Peter K
PK
D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D019736:Prostheses and Implants; D016896:Treatment Outcome; D014521:Urethra / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods*