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MP63-09: Prediction of the long-term durability of suburethral sling based on postoperative urodynamics

Sunday, May 14
3:30 PM - 5:30 PM
Location: BCEC: Room 153

Presentation Authors: Hsin-Ho Liu*, Taichung, Taiwan, Hann-Chorng Kuo, Hualien, Taiwan

Introduction: Although a high success rate has been achieved in the early follow-up after suburethral sling for stress urinary incontinence(SUI), there are limited data about long-term effects. The objective of this study is to survey the long-term durability of suburethral sling for SUI and to identify urodynamic changes that are correlated with successful outcomes.

Methods: Totally 309 women underwent 331 retropubic suburethral slings for SUI between 1989 and 2014 in this survey. Patients received standardized urodynamic testing preoperatively as the baseline and postoperatively within 6 months. Surgical results, demographic characteristics, urodynamic parameters, and postoperative clinical manifestation were retrospectively analyzed.

Results: The median follow-up period was 86.6 months. The overall subjective cure rate was 82.5%. Previous SUI surgery has negative influence on cure rate (P .048). 6.2% de novo urge urinary incontinence (UUI) in the successes, but none in the failure group (P .049). Persistent UUI after sling surgery was noted in 66 (24.2%) in the successes and 40 (69%) in the failures (P<.001). 107 women (39.2%) experienced UUI resolution in the successes, and 10 (17.2%) in the failures (P .001). Among successes, a significant interaction (P<.001) was detected between the baseline and postoperative urodynamic parameters, including Qmax, corrected Qmax, postvoid residual (PVR), voiding volume, voiding efficiency(VE), and bladder outlet obstruction index (BOOI). Significantly increased PdetQmax was also observed after surgery (P .015). A significant interaction (P .034) is detected from the baseline to 6 months between successes and failures for BOOI.

Conclusions: Suburethral sling has a durable long-term effect in our study. There is a trend suggesting that the decreased Qmax, corrected Qmax and VE are associated with surgical success, while increased Pdet.Qmax, BOOI, and PVR are also associated with success. Slight obstruction makes efficacious sling surgery. The increased outlet resistance is essential for achieving dryness.

Source Of Funding: none

Hsin-Ho Liu, MD

Dr. Hsin-Ho Liu received her medical training from China Medical University Hospital, Taichung, Taiwan. She completed her urology training at the China Medical University Hospital, and continued to complete the fellowship. She became a staff member in the Urology Department of China Medical University Hospital in 2006. She is an attending physician in the Urology Department in Taichung Tzu Chi Hospital since 2007.

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