Long-term functional results after unilateral mid-urethral sling transection for voiding dysfunction.
OBJECTIVE
To investigate the long-term outcomes of unilateral mid-urethral sling transection to treat voiding dysfunction after synthetic mid-urethral sling placement for stress urinary incontinence.


METHODS
Twenty-three patients who underwent an unilateral sling transection were analyzed retrospectively. Patient records were analyzed for subjective outcome, and pre- and postoperative flow patterns were used as objective outcome parameters.


RESULTS
At the first postoperative follow-up, 77.3% of the patients remained dry. After a mean follow-up of 42 months, 73.9% of patients were continent. The flow pattern after lateral sling transection was significantly better than pre-operatively, with higher maximum flow rate (24.2ml/s, p=0.001), higher mean flow rate (10.4ml/s, p=0.001), higher voided volume (308.5ml, p=0.002) and lower residual volume (28.7ml, p=0.003). At final postoperative follow-up, eight patients (34.8%) reported urgency and six patients (26.1%) were incontinent; four of these patients (17.4%) mainly had urge incontinence.


CONCLUSIONS
Unilateral mid-urethral sling transection is a safe, effective technique to treat voiding symptoms with good preservation of continence. The technique repairs the obstructive flow effectively. Urgency and urge incontinence after mid-urethral sling placement are difficult to treat with transection alone.
Department of Urology, Saint-John's Hospital, Brugge, Belgium; Department of Urology, University Hospitals, Leuven, Belgium. Electronic address: f.baekelandt@telenet.be.
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F
Baekelandt
Department of Urology, Saint-John's Hospital, Brugge, Belgium.
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P
Van Oyen
Department of Urology, Saint-John's Hospital, Brugge, Belgium.
C
C
Ghysel
Department of Urology, University Hospitals, Leuven, Belgium.
F
F
Van der Aa
Department of Urology, Saint-John's Hospital, Brugge, Belgium.
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Ampe
D001530:Belgium / Q000453:epidemiology; D015331:Cohort Studies; D004414:Dyspareunia / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D057286:Electronic Health Records; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk; D055502:Secondary Prevention; D053825:Suburethral Slings / Q000009:adverse effects*; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D053202:Urinary Incontinence, Urge / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D016055:Urinary Retention / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D014563:Urodynamics
Sling transection; Stress urinary incontinence; Synthetic mid-urethral sling; Urge urinary incontinence; Urgency