Predicting for postoperative incontinence following sling incision.

INTRODUCTION AND HYPOTHESIS: Our objective was to assess preoperative risk factors for developing recurrent stress urinary incontinence (SUI) following transvaginal sling incision (TVSI) for bladder outlet obstruction (BOO).

METHODS

We identified 101 women who underwent TVSI and/or removal of a midurethral sling. Thirty-nine underwent TVSI for clinical and videourodynamic demonstrable BOO. Eighteen of 39 women demonstrated preoperative clinical SUI and urodynamic BOO. A comparative analysis was performed specifically looking at several clinical factors and the risk of the occurrence of postoperative SUI.

RESULTS

Mean age, number of prior surgeries, parity, and pre- and postoperative PVRs did not predict for postoperative SUI. Nine of 18 (50%) of women with SUI and BOO preoperatively vs. only 2/21 (10%) of women with BOO alone developed postoperative SUI. This difference in the incidence of postoperative SUI was statistically significant (p<0.01).

CONCLUSIONS

In patients with BOO, the presence of preoperative clinical SUI is a predictor for postoperative SUI following TVSI.