title: Outcomes of three sling procedures at the time of abdominal sacral colpopexy.
abstract: A sling at time of sacral colpopexy (SCP) for apical pelvic organ prolapse (POP) is valuable in the treatment of overt, urodynamic, and occult stress urinary incontinence (SUI). As there is no current agreement regarding the optimal choice of sling in these women, we compare the outcomes of three sling procedures in this population: autologous rectus fascia bladder neck sling (ARF), retropubic midurethral sling (RPM), and transobturator midurethral sling (TOM).
  
  
  
  We performed a retrospective single institution, single-surgeon review of data identifying women with minimum follow-up of 12 months who underwent a concomitant sling and SCP following urodynamics with and without POP reduction. Preoperative and postoperative evaluation included objective and subjective assessment. Cure required absence of subjective and objective SUI.
  
  
  
  Out of 187 women, 152 (81%) met inclusion criteria (49 ARF, 58 RPM, and 45 TOM). There were no significant differences among sling groups regarding demographics. SUI cure rates were not significantly different between sling groups, or within each group after stratification by overt and occult SUI. QoL indices improved significantly after surgery for the entire cohort.
  
  
  
  All three sling types appear to produce similar cure rates of SUI when done concomitantly with SCP. There did not appear to be any significant differences when stratified by occult or overt SUI. No sling type was associated with more postoperative complications. Larger studies are necessary to confirm the findings of this single-institution, retrospective study. Neurourol. Urodynam. 36:482-485, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Urology, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Ryan W
authors.initials: RW
authors.lastname: Tubre
authors.affiliation: Department of Urology, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Priya
authors.initials: P
authors.lastname: Padmanabhan
authors.affiliation: Department of Urology, Louisiana State University Health Sciences Center, Shreveport, Louisiana.
authors.forename: Clifton F
authors.initials: CF
authors.lastname: Frilot
authors.affiliation: Department of Urology, Louisiana State University Health Sciences Center, Shreveport, Louisiana.
authors.forename: Wesley
authors.initials: W
authors.lastname: Porta
authors.affiliation: Department of Urology, Louisiana State University Health Sciences Center, Shreveport, Louisiana.
authors.forename: Alex
authors.initials: A
authors.lastname: Gomelsky
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012447:Sacrum / Q000601:surgery*; D053825:Suburethral Slings; D016896:Treatment Outcome; D014563:Urodynamics / Q000502:physiology*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*
keywords: pelvic organ prolapse; sacrocolpopexy; stress incontinence