Abstract
Introduction and hypothesis
We aim to determine the presentation of and immediate and longer-term outcomes of vaginal surgical excision of urethral extrusion of mid-urethral tape (MUT).
Methods
We performed a retrospective analysis of all patients with urethral extrusion of MUT having vaginal surgical excision between 2007 and 2018. The MUT was removed either partially (via vaginal approach) or completely (via combined vaginal and laparoscopic approach). Functional outcomes and any re-interventions are described.
Results
Thirty-four patients of median age 53 (range 34–82) years were identified. Preoperative symptomatic recurrent/persistent urinary incontinence was present in 29/34(85%) with 24/34(71%) women having recurrent/persistent stress urinary incontinence (SUI) or stress predominant mixed urinary incontinence (s-MUI) on urodynamics. Vaginal surgical excision was performed alone in 33/34(97%) women and in combination with laparoscopic removal of abdominopelvic MUT in 1/34(3%) woman. In the longer term vaginal/urethral pain resolved or improved in all 15/15(100%) patients presenting with this complaint whilst patient reported poor flow resolved in 8/9 (89%) women. Twenty-eight of 34 women (82%) had persistent/recurrent SUI or s-MUI following MUT excision. Twenty-four of 34 women (71%) had further SUI surgery with cure or improvement of SUI in 20/24 (83%) patients.
Conclusions
The outcome of vaginal surgical excision of the MUT was cure or improvement of pain in 100% and resolution of poor flow in 89% women. Recurrent/persistent SUI or s-MUI was present in 82% following removal as compared to 71% women prior to removal. Of the 71% of women electing to have further surgery for recurrent/persistent SUI/s-MUI, 83% were dry or improved afterwards.
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B Toia: Data collection, Data analysis, Manuscript writing/editing.
S Unterberg: Manuscript writing/editing.
N Sihra: Data collection.
M Pazkad: Protocol/project development.
R Hamid: Protocol/project development.
JL Ockrim: Protocol/project development.
TJ Greenwell: Protocol/project development, Data analysis, Manuscript writing/editing.
All authors reviewed and edited the manuscript and approved the final version of the manuscript.
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Toia, B., Unterberg, S., Sihra, N. et al. Functional outcomes of vaginal surgery for urethral extrusion of mid-urethral tape in women. Int Urogynecol J 33, 2251–2256 (2022). https://doi.org/10.1007/s00192-021-04774-2
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DOI: https://doi.org/10.1007/s00192-021-04774-2