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

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.