Management of Recurrent Stress Urinary Incontinence After Failed Mid-Urethral Sling Placement
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Purpose of Review
Our objective is to review the current literature on recurrent stress urinary incontinence after mid-urethral sling placement, focusing on evidence-based management considerations for this complex clinical problem.
Conservative, minimally invasive surgical therapies are currently available for management of persistent or recurrent SUI after a previous mid-urethral sling (MUS).
Our review of the literature does not show a clear benefit of one approach over others and emphasizes that the ideal management for these complex patients should be determined using an individualized approach with a detailed discussion of patient symptoms, past surgical history, and goals. For symptomatic patients who are surgical candidates and desire intervention, trans-urethral bulking agents, repeat retropubic (RP) MUS, or salvage autologous pubovaginal (PV) sling appear to be the most well-described management strategies.
KeywordsUrinary incontinence Mid-urethral sling Pubovaginal sling Sling failure
Compliance with Ethical Standards
The research contained in this study did not directly involve human subjects and/or animals and thus no informed consent was necessary.
Conflict of Interest
The authors of this manuscript declare that Dr. Padmanabhan serves as a consultant and speaker for Astellas and consultant for Allergan. Dr. Fontenot has no conflict of interest.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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