Patient Satisfaction after Sling Revision for Voiding Dysfunction after Sling Placement

Shunaha Kim-Fine, Sherif A. El-Nashar, Brian J. Linder, Elizabeth R. Casiano, Joshua L. Woelk, John B. Gebhart, Christopher J. Klingele, Emanuel C. Trabuco

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Objective: The aim of this study was to evaluate patient-reported outcomes after sling release for obstructive voiding after sling operation for female stress urinary incontinence. Methods: All female patients who had sling release for obstructive voiding at Mayo Clinic in Rochester, Minnesota, from January 1, 2000, through October 31, 2008, were identified and mailed a survey including validated questions for voiding symptoms. A composite outcome for surgical success was chosen in which participants reported global improvement (at least "much better") and complete satisfaction on a 7-point Likert scale. Logistic regression analysis was used to identify clinical and surgical predictors of this outcome. Results: In total, 101 women were identified, of which 98 were alive at the time of mailing, and 55 women (56.1%) responded to the survey. Surgery before sling releasewas a syntheticmidurethal sling in 62 patients and biologic sling in 39 patients. Clinical characteristics among mailing responders and nonresponders were similar aside from time from revision surgery to survey (median, 38.8 vs 54.6 months; P = 0.05). Overall, 23 (41.8%) of the 55 responding patients met the predefined criteria for surgical success. Multivariable analysis identified age younger than 60 years (odds ratio [OR], 4.22; P = 0.02), absence of overactive bladder symptoms before sling release (OR, 3.99; P = 0.04), and type of sling release (sling incision or loosening vs partial or complete excision) (OR, 3.78; P = 0.05) as predictors of success. Conclusions: Of responders, 23 (41.8%) reported global improvement and satisfaction. Younger age, lack of documented overactive bladder symptoms before sling release, and performing sling release with sling incision or loosening rather than partial or complete excision were associated with better satisfaction and patient-reported improvement.

Original languageEnglish (US)
Pages (from-to)140-145
Number of pages6
JournalFemale Pelvic Medicine and Reconstructive Surgery
Volume22
Issue number3
DOIs
StatePublished - May 1 2016
Externally publishedYes

Keywords

  • complication of urinary incontinence surgery
  • incomplete bladder emptying
  • sling
  • urethrolysis
  • voiding dysfunction

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology
  • Urology

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  • Cite this

    Kim-Fine, S., El-Nashar, S. A., Linder, B. J., Casiano, E. R., Woelk, J. L., Gebhart, J. B., Klingele, C. J., & Trabuco, E. C. (2016). Patient Satisfaction after Sling Revision for Voiding Dysfunction after Sling Placement. Female Pelvic Medicine and Reconstructive Surgery, 22(3), 140-145. https://doi.org/10.1097/SPV.0000000000000242