n South African Journal of Obstetrics and Gynaecology - Suburethral sling procedures after previous surgery for urinary incontinence or pelvic organ prolapse : research article

Volume 13, Issue 2
  • ISSN : 0038-2329
  • E-ISSN: 2078-5135



. To compare the outcome of suburethral sling procedures (tension-free vaginal tape (TVT), obturator tape (Ob-tape)) for stress urinary incontinence (SUI) in women with previous surgery for SUI or pelvic organ prolapse (POP).

. A comparative, descriptive, retrospective study was done using information drawn from a urogynaecological database of 195 women with urinary incontinence. We divided 195 women into a group with previous surgery for urinary incontinence or POP (study group, = 106) and a group without previous incontinence surgery (control group, = 89). All women underwent a TVT (86%) or Ob-tape procedure (14%). The mean follow-up in the study group was 25 months (range 2 - 61 months) and in the control group 24 months (range 1 - 49 months). Since a urodynamic evaluation facility was not available for most women, the diagnosis of SIU and other types of incontinence was made clinically.
. On admission 43 women in the study group presented with SUI (40.6%), compared with 34 in the control group (38.2%) (95% confidence interval (CI) -11.3%; 15.7%). Urge incontinence was present in 10 women in the study group (9.4%) and 6 in the control group (6.7%) (95% CI -5.7%; 10.6%). Mixed incontinence was present in 47 (44.3%) of the study group and 39 (43.8%) of the control group (CI -13.3%; 14.2%). The diagnosis was unknown in 6 women in the study group and 10 in the control group.
Following surgery, SUI recurred in 25 (23.6%) women in the study group and 12 (13.5%) in the control group (95% CI -1.0%; 20.6%). Overactive bladder symptoms were present postoperatively in 43 women in the study group women (40.6%) and 39 controls (43.8%) (95% CI -16.9%; 10.4%).
Follow-up surgery was performed in 14 women in the study group (13.2%) and 6 controls (6.7%) (95% CI -2.4%; 15.0%). Included were mesh removals (4 study group, 1 control), Burch colposuspension (1 and 2, respectively), and TVT or Ob-tape (2 and 1, respectively).
. Statistically, previous surgery was not a risk factor for recurrent SUI, but a tendency was observed towards more SUI in these women.

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