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Overactive Bladder 5 Years After the Mid-Urethral Sling Tensioning (MUST) Trial.
Taylor Hughes1, Amy Metcalfe1,2,3, Miranda Fidler-Benaoudia1,4,5
1Departments of Community Health Sciences.
Urogynecology (Philadelphia, Pa.)
|May 18, 2026
Summary
Midurethral sling surgery often improves overactive bladder (OAB) symptoms, though some patients experience worsening. Most OAB medication use after surgery is temporary, with many discontinuing long-term.
Area of Science:
- Urology
- Gynecology
- Pelvic Floor Disorders
Background:
- Midurethral sling (MUS) procedures are standard for stress urinary incontinence.
- MUS surgery can impact overactive bladder (OAB) symptoms.
Purpose of the Study:
- To assess the 5-year burden of OAB after MUS insertion.
- To compare OAB outcomes based on sling tensioning techniques.
Main Methods:
- Prospective cohort study of 318 participants in the Mid-Urethral Sling Tensioning trial.
- Validated OAB questionnaires and administrative health data were used.
- Data collected pre-surgery and 5 years post-surgery.
Main Results:
- 81.5% had OAB symptoms at 5 years post-MUS; 19-22.5% reported worsening.
- 38.7-47.6% reported significant improvement in OAB symptoms.
- 21.4% used OAB medication post-surgery, with 5.3% persisting; 2.2% had Botox procedures.
Conclusions:
- More patients improved than worsened regarding OAB symptoms post-MUS.
- OAB medication trials were common but mostly discontinued.
- Surgeons and patients should have realistic OAB expectations after MUS.
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