title: Risk factors for failure of retropubic and transobturator midurethral slings.
abstract: OBJECTIVE
  The aim of our study was to identify and compare risk factors for failure of retropubic and transobturator procedures.
  
  
  METHODS
  This was a retrospective cohort study. Women with predominant stress urinary incontinence who underwent a retropubic (n = 214) or transobturator tape procedure (n = 173) were included. Therapy was considered to have failed in women reporting any amount of urine leakage during stress after 2 and/or 12 months.
  
  
  RESULTS
  Risk factors for failure were mixed urinary incontinence (MUI; odds ratio [OR], 3.7; 95% confidence interval [CI], 1.5-9.1) and the observation of detrusor overactivity (DO) at urodynamics (OR, 8.6; 95% CI, 1.9-39.4) in the retropubic group. Reporting a history of previous incontinence surgery (OR, 3.9; 95% CI, 1.3-11.7) and a low mean urethral closure pressure (MUCP) at urodynamics (OR, 14.5; 95% CI, 1.5-139.0) were risk factors for failure in the transobturator group.
  
  
  CONCLUSIONS
  Women with previous incontinence surgery or a low MUCP might benefit more from a retropubic sling, whereas a transobturator procedure might be preferable in women with MUI or DO.
authors: Department of Obstetrics and Gynecology, St. Elisabeth Hospital Tilburg, Tilburg, The Netherlands. marijnhouwert@hotmail.com
authors: R Marijn
authors: RM
authors: Houwert
authors: Pieter L
authors: PL
authors: Venema
authors: Annelies E
authors: AE
authors: Aquarius
authors: Hein W
authors: HW
authors: Bruinse
authors: Jan Paul W R
authors: JP
authors: Roovers
authors: Harry A M
authors: HA
authors: Vervest
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D053825:Suburethral Slings / Q000009:adverse effects* / Q000706:statistics & numerical data*; D017211:Treatment Failure; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D014563:Urodynamics