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Risk factors for failure of retropubic and transobturator midurethral slings
R Marijn Houwert1, Pieter L Venema, Annelies E Aquarius
1Department of Obstetrics and Gynecology, St. Elisabeth Hospital Tilburg, Tilburg, The Netherlands. marijnhouwert@hotmail.com
Objective:
The aim of our study was to identify and compare risk factors for failure of retropubic and transobturator procedures.
Study Design:
This was a retrospective cohort study. Women with predominant stress urinary incontinence who underwent a retropubic (n = 214) or transobturator tape procedure (n = 173) were included. Therapy was considered to have failed in women reporting any amount of urine leakage during stress after 2 and/or 12 months.
Results:
Risk factors for failure were mixed urinary incontinence (MUI; odds ratio [OR], 3.7; 95% confidence interval [CI], 1.5-9.1) and the observation of detrusor overactivity (DO) at urodynamics (OR, 8.6; 95% CI, 1.9-39.4) in the retropubic group. Reporting a history of previous incontinence surgery (OR, 3.9; 95% CI, 1.3-11.7) and a low mean urethral closure pressure (MUCP) at urodynamics (OR, 14.5; 95% CI, 1.5-139.0) were risk factors for failure in the transobturator group.
Conclusion:
Women with previous incontinence surgery or a low MUCP might benefit more from a retropubic sling, whereas a transobturator procedure might be preferable in women with MUI or DO.
