Volume at First Leak Is Associated With Sling Failure Among Women With Stress Urinary Incontinence.

Area of Science:

• Urology
• Female Pelvic Medicine and Reconstructive Surgery

Background:

• Stress urinary incontinence (SUI) at low bladder volumes is common but poorly understood regarding treatment.
• Midurethral slings are a common surgical treatment for SUI.

Purpose of the Study:

• To investigate the association between the bladder volume at first leak and the success of midurethral sling procedures for SUI.

Main Methods:

• Retrospective cohort study of 168 women undergoing sling surgery for SUI.
• Analysis of urodynamic parameters, including bladder volume at first leak, and sling outcomes (success vs. failure).
• Sling failure defined as repeat surgery or persistent/worsened leakage; success defined as subjective improvement or dryness.

Main Results:

• Overall sling failure rates were similar for transobturator (10%) and retropubic (7.6%) slings.
• No significant association found between preoperative urodynamic parameters (except bladder volume at first leak), BMI, age, or prior procedures and sling success.
• Each 50 mL increase in bladder volume at first leak was associated with a 1.576-fold increased odds of sling success (P=0.04).

Conclusions:

• Bladder volume at first leak is a significant predictor of midurethral sling success in women with SUI.
• This finding can help in patient selection and counseling for SUI surgical management.