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Updated: Jul 4, 2026

Retzius-Sparing Robot-Assisted Radical Prostatectomy
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Long-Term Outcomes After Retropubic and Transobturator Sling Procedures: Reoperation for Recurrent Stress Urinary

Ayssa Teles Abrao Trad1, Sherif A El Nashar2, Brian J Linder3

  • 1Department of Obstetrics and Gynecology, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA.

BJOG : an International Journal of Obstetrics and Gynaecology
|July 2, 2026
PubMed
Summary

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Midurethral slings show low long-term failure rates for stress urinary incontinence (SUI). Transobturator slings combined with prolapse repair increase reoperation risk, while retropubic slings raise urinary retention concerns.

Area of Science:

  • Urology
  • Gynecology
  • Pelvic Floor Surgery

Background:

  • Stress urinary incontinence (SUI) significantly impacts quality of life.
  • Midurethral slings are a common surgical treatment for SUI.
  • Long-term outcomes and comparative complication rates of different sling types require ongoing evaluation.

Purpose of the Study:

  • To compare the long-term failure rates and complications of retropubic and transobturator midurethral sling procedures for primary SUI.
  • To assess reoperation rates and specific complications associated with each sling type over an extended follow-up period.

Main Methods:

  • Retrospective cohort study at an academic medical center.
  • Involved a previously described cohort undergoing midurethral slings (2002-2012) with extended follow-up through December 31, 2022.
Keywords:
midurethral slingspostoperative complicationsreoperationstress urinary incontinence

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  • Evaluated treatment failure (reoperation for recurrent SUI) and procedure-associated complications.

    • Main Results:

    • Extended follow-up revealed a higher risk of reoperation with transobturator slings (8.8%) compared to retropubic slings (4.4%).
    • The risk of reoperation with transobturator slings was significantly higher when combined with prolapse repair.
    • Retropubic slings were associated with a higher rate of reoperation for urinary retention.

    Conclusions:

    • Midurethral sling procedures demonstrate a low overall failure rate in the long term.
    • Transobturator slings combined with prolapse repair necessitate careful consideration due to increased reoperation risk.
    • Retropubic slings carry a higher risk of urinary retention requiring intervention.