Comparison of midurethral sling outcomes with and without prolapse repair

To compare the outcome of single incision and retropubic midurethral slings when performed with and without concomitant repair of pelvic organ prolapse (POP).

A retrospective chart review was conducted of all midurethral slings performed with and without concomitant POP repair by a single provider from September 2008 to April 2010. Prolapse was repaired transvaginally with light-weight polypropylene mesh or robotically via sacrocolpopexy based on the nature of the prolapse and surgeon preference. Success of the sling procedure was defined as complete resolution of leakage or great improvement of leakage based on the Patient Global Impression of Improvement score.

Eighty-nine patients underwent a midurethral sling procedure. Forty-five patients received a single incision sling, 18 of which had concomitant POP repair. Forty-four received a retropubic sling, 16 of which had concomitant POP repair. Successful treatment of SUI in the single incision sling group was 89% (24/27) which was not significantly different from the retropubic only sling group 93% (26/28), p = 0.61. However, a significant difference was seen in the successful treatment of SUI in the single incision sling plus prolapse repair group 67% (12/18) versus the retropubic sling plus prolapse repair group 94% (15/16), p = 0.05.

We found a higher incidence of single incision mid-urethral sling failure when done at the same time as repair of pelvic organ prolapse in comparison to sling placement alone. There is no difference in the success of retropubic slings when done with or without concomitant prolapse repair.