title: Are suburethral slings less successful in the elderly?
abstract: OBJECTIVE
  We aimed to evaluate the success of suburethral slings in women ≥70 years of age.
  
  
  METHODS
  This was a retrospective cohort study of women who underwent suburethral sling placement. Subjects were separated into three groups: ≤50 years of age (group 1), 51 to 69 years of age (group 2), and ≥70 years of age (group 3). The primary aim was to evaluate success as defined by ≥ improved on a validated patient improvement satisfaction score and a negative postoperative standardized stress test.
  
  
  RESULTS
  There were 1,464 subjects. Mean age was 44.51 ± 4.25 (n = 296) for group 1, 60.5 ± 5.28 (n = 680) for group 2, and 77.68 ± 5.41 (n = 488) for group 3. The median follow-up was 26 (6-498) weeks, 45 (6-498) weeks, and 42 (6-543) weeks, for groups 1, 2, and 3 respectively. Multiple logistic regression analysis demonstrated no difference in sling success according to age stratification. Lower success was associated with having had a previous sling (adjusted OR 0.25, 95 % CI 0.12-0.5), having detrusor overactivity (adjusted OR 0.44, 95 % CI 0.28-0.69), and having a history of urge urinary incontinence (UUI) for ≥ 4 years (adjusted OR 0.54, 95 % CI 0.31-0.95).
  
  
  CONCLUSIONS
  There is no difference in sling success between the elderly and younger populations. However, those with previous sling surgery or a long standing history of UUI may be at a higher risk of failure.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA.
authors.forename: Alexandriah
authors.initials: A
authors.lastname: Alas
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Orawee
authors.initials: O
authors.lastname: Chinthakanan
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA.
authors.forename: Luis
authors.initials: L
authors.lastname: Espaillat
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA.
authors.forename: Leon
authors.initials: L
authors.lastname: Plowright
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA.
authors.forename: Vivian
authors.initials: V
authors.lastname: Aguilar
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA. davilag@ccf.org.
authors.forename: G Willy
authors.initials: GW
authors.lastname: Davila
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D053825:Suburethral Slings / Q000706:statistics & numerical data*; D014549:Urinary Incontinence / Q000601:surgery*
keywords: Elderly; Midurethral slings; Stress urinary incontinence