Poster, Podium & Video Sessions
Presentation Authors: Brian Linder*, Emanuel Trabuco, John Gebhart, Christopher Klingele, John Occhino, Daniel Elliott, Deborah Lightner, Rochester, MN
Introduction: To evaluate the utility of urodynamic studies, performed before primary midurethral sling placement for stress urinary incontinence, in predicting the need for subsequent sling release for voiding dysfunction.
Methods: The health records of women managed with primary synthetic midurethral sling placement at Mayo Clinic (Rochester, Minnesota) from January 1, 2002, through December 31, 2012, were reviewed. The primary outcome was surgical sling release for postoperative voiding dysfunction (ie, prolonged retention, elevated postvoid residual volumes with new voiding symptoms, or de novo onset or worsening of overactive bladder symptoms). Logistic regression models were used to evaluate associations between potential clinical risk factors and the primary outcome.
Results: Overall, 1,629 women underwent primary synthetic midurethral sling placement during the study timeframe, including 1,081 patients (66%) who underwent a preoperative multichannel urodynamic evaluation. A sling release for voiding dysfunction was performed for 51 patients (3.1%) at a median of 1.9 months postoperatively (interquartile range, 1.3-9.3 months). Patients undergoing sling release were significantly more likely to have had retropubic sling placement (P=.003) and concomitant prolapse surgery (P=.005). On univariate analysis, no urodynamic parameters were associated with the risk of sling release; evaluated parameters included peak flow rate (P=.20), postvoid residual volume (P=.37), voiding without detrusor contraction (P=.96), and detrusor pressure at maximal flow (P=.23).
Conclusions: Sling release for voiding dysfunction was rare in our cohort. No urodynamic parameters were associated with the risk of sling release.
Source Of Funding: None