title: Safety and Efficacy of Retropubic Mid-urethral Sling Placement in Women Who Void With Valsalva.
abstract: To compare outcomes after retropubic sling (RPS) in women with and without Valsalva voiding.
  
  
  
  Women who underwent RPS for stress incontinence from 2010 to 2014 were identified and their baseline characteristics were examined. Valsalva voiding was defined as abdominal straining throughout voiding on preoperative urodynamics. Sub-analysis of those with Valsalva included a subset with detrusor underactivity on urodynamics. Follow-up was at 1, 3, 6, and 12 months. Primary outcomes were rates of subjective success, revisions, complications, and voiding dysfunction. Secondary measures were Urogenital Distress Inventory (UDI-6) score, Incontinence Impact Questionnaire (IIQ-7) score, post-void residual, and pad use.
  
  
  
  Subjects (n = 141) analyzed included 75 Valsalva voiders (VV) and 66 non-Valsalva voiders. At baseline, there were no differences in age, race, comorbidity, post-void residual, pad use, UDI-6, or capacity. Postoperatively, there were no differences in rates of passing initial void trial, need for clean intermittent catheterization, revisions, complications, or voiding dysfunction. No differences in pad use, UDI-6, or IIQ-7 were seen at 6 or 12 months. Within VV, no differences between patients with and without detrusor underactivity were seen for any primary or secondary outcomes (all P > .05).
  
  
  
  In patients who void with Valsalva, RPS appears to be safe and effective. Between VV and non-Valsalva voiders, there were no differences in rates of subjective success, revisions, or complications, even in patients with Valsalva voiding without appreciable detrusor contraction.
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago, Chicago, IL. Electronic address: blake.anderson@uchospitals.edu.
authors.forename: Blake B
authors.initials: BB
authors.lastname: Anderson
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago, Chicago, IL.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Pariser
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago, Chicago, IL.
authors.forename: Shane M
authors.initials: SM
authors.lastname: Pearce
authors.affiliation: Department of Obstetrics and Gynecology, Mount Sinai Hospital, Chicago, IL.
authors.forename: Jessica G
authors.initials: JG
authors.lastname: Volsky
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago, Chicago, IL.
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Bales
authors.affiliation: Department of Urology, Columbia University, New York, NY.
authors.forename: Doreen E
authors.initials: DE
authors.lastname: Chung
mesh_terms: D005260:Female; D006801:Humans; D019919:Prosthesis Implantation / Q000009:adverse effects; D012189:Retrospective Studies; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014554:Urination; D013520:Urologic Surgical Procedures / Q000379:methods