We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Management of recurrent stress urinary incontinence after failed midurethral sling: a survey of members of the International Urogynecological Association (IUGA).
- Authors
Giarenis, Ilias; Thiagamoorthy, Ganesh; Zacchè, Martino; Robinson, Dudley; Cardozo, Linda
- Abstract
Introduction and hypothesis: Synthetic midurethral slings (MUS) have gained popularity in the management of stress urinary incontinence (SUI), due to their efficacy and minimally invasive nature. As there are no robust data to guide management of persistent or recurrent SUI after failed MUS, the aim of this study was to evaluate the management of these cases among IUGA members. Methods: A pretested, web-based survey designed to explore assessment, surgical management and views about future research was sent to IUGA members. Results: A total of 385 participants opened the survey and 331 eligible responses were obtained. Conventional laboratory urodynamics were the most commonly used investigation (72.6 %). The type of previous surgery, urodynamic findings and surgeon's preference/experience were considered to be the most important factors in choosing the type of surgical management. Retropubic sling (RPS) was the preferred surgical option in most of the clinical scenarios with urethral bulking agents (UBA) being more popular in the absence of urethral hypermobility after a failed RPS. While the vast majority of the respondents (93.0 %) recognized the urgent need for good quality research, they were less willing to participate in randomized controlled trials (RCT) comparing redo MUS with autologous fascial sling or colposuspension. Conclusions: Members of IUGA prefer RPS in most patients and UBA in patients with absent urethral hypermobility and intrinsic sphincter deficiency. There is a recognized need for good quality research, but IUGA members are reluctant to participate in RCTs comparing minimally invasive to conventional surgical techniques.
- Subjects
TREATMENT of urinary stress incontinence; URETHRA surgery; TREATMENT effectiveness; URODYNAMICS; DISEASE relapse
- Publication
International Urogynecology Journal, 2015, Vol 26, Issue 9, p1285
- ISSN
0937-3462
- Publication type
Article
- DOI
10.1007/s00192-015-2696-7