title: Comparison of retropubic synthetic mid-urethral slings to fascia pubovaginal slings following failed sling surgery.
abstract: Mid-urethral slings are considered first-line surgical treatment of stress urinary incontinence. However, there is a paucity of data regarding the use of mid-urethral slings (MUS) for patients who have failed a prior sling procedure.
  
  
  
  After receiving IRB approval, a multi-institutional retrospective review of 224 consecutive patients undergoing placement of a retropubic MUS (n = 153) or autologous rectus fascia (ARF) pubovaginal sling (n = 71) for prior failed sling surgery is conducted. Pre- and post-operative pad use is recorded for all patients in addition to completion of four validated questionnaires pre- and post-operatively: SEAPI-QMM incontinence classification system (stress-related leak, emptying ability, anatomy, protection, inhibition, quality of life, mobility, and mental status), incontinence impact questionnaire (IIQ-7), urogenital distress inventory (UDI-6), and 10-point visual analog score (VAS).
  
  
  
  Median follow-up is 29 months and the overall subjective cure rate was 61.4%. A statistically significant improvement in pad use and in all validated questionnaire outcomes is observed for secondary repair with a retropubic sling. In further sub-analysis between the MUS and the ARF groups, there are no significant differences in subjective cure rates or changes in post-operative questionnaire outcomes.
  
  
  
  Secondary repair with a retropubic sling is a durable and effective procedure for patients who have failed prior sling procedures without differences in outcomes noted between retropubic MUS and ARF slings. Neurourol. Urodynam. 35:851-854, 2016. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Urology, The University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Michael
authors.initials: M
authors.lastname: Aberger
authors.affiliation: Department of Urology, Louisiana State University Health, Shreveport, Louisiana.
authors.forename: Alexander
authors.initials: A
authors.lastname: Gomelsky
authors.affiliation: Department of Urology, The University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Priya
authors.initials: P
authors.lastname: Padmanabhan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D012086:Reoperation; D012189:Retrospective Studies; D053825:Suburethral Slings; D013526:Surgical Mesh; D017211:Treatment Failure; D014550:Urinary Incontinence, Stress / Q000601:surgery*
keywords: midurethral slings; reoperation; stress urinary incontinence; surgical mesh