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Does concomitant prolapse repair at the time of midurethral sling affect recurrent rates of incontinence?

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Abstract

Introduction and hypothesis

We compared outcomes after midurethral sling (MUS) with and without concomitant repair for prolapse.

Methods

Women who underwent MUS with or without concomitant repair for prolapse completed a follow-up survey. Outcomes were assessed with validated questionnaires and medical record review. Kaplan–Meier, Cox proportional hazards regression, and logistic regression models were used for analysis.

Results

Of 317 women, 281 (89%) responded to the survey. During a median follow-up of 2.7 years, survival free of “any” incontinence (Incontinence Severity Index score, >0) was similar in both groups (adjusted hazard ratio, 1.07; P = 0.77). Women with concomitant repair for advanced prolapse tended to be more bothered by frequent urination (adjusted odds ratio, 1.78; P = 0.08) and more likely to require urethrolysis (odds ratio, 6.11; P = 0.04) than those without concomitant pelvic floor repair.

Conclusions

Prolapse repairs concomitant with MUS did not affect incontinence recurrence. However, repairs may cause increased lower urinary tract symptoms.

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Abbreviations

BMI:

Body mass index

ISI:

Incontinence Severity Index

LUTS:

Lower urinary tract symptoms

MUS:

Midurethral sling

OR:

Odds ratio

SUI:

Stress urinary incontinence

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Conflicts of interest

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Authors and Affiliations

  1. Division of Gynecologic Surgery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Elizabeth R. Casiano, John B. Gebhart, Christopher J. Klingele & Emanuel C. Trabuco

  2. Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Michaela E. McGree & Amy L. Weaver

Authors
  1. Elizabeth R. Casiano
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  2. John B. Gebhart
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  3. Michaela E. McGree
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  4. Amy L. Weaver
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  5. Christopher J. Klingele
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  6. Emanuel C. Trabuco
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Corresponding author

Correspondence to Elizabeth R. Casiano.

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Casiano, E.R., Gebhart, J.B., McGree, M.E. et al. Does concomitant prolapse repair at the time of midurethral sling affect recurrent rates of incontinence?. Int Urogynecol J 22, 819–825 (2011). https://doi.org/10.1007/s00192-011-1367-6

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  • DOI: https://doi.org/10.1007/s00192-011-1367-6

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