Autologous mid-urethral fascial sling for stress urinary incontinence: Long term outcomes
There has been an increasing interest in mesh-free surgical options for Stress Urinary Incontinence (SUI). Traditionally rectus fascia autologous slings were placed at the bladder neck but more recently they are positioned at the mid-urethra (aMUS). The long-term outcomes for these patients are des...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2021-09-01
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| Series: | Urogynaecologia International Journal |
| Subjects: | |
| Online Access: | http://www.urogynaecologia.org/index.php/uij/article/view/272 |
| _version_ | 1818507929978929152 |
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| author | Theo Malthouse Ian Rudd Chris Down James Moore |
| author_facet | Theo Malthouse Ian Rudd Chris Down James Moore |
| author_sort | Theo Malthouse |
| collection | DOAJ |
| description |
There has been an increasing interest in mesh-free surgical options for Stress Urinary Incontinence (SUI). Traditionally rectus fascia autologous slings were placed at the bladder neck but more recently they are positioned at the mid-urethra (aMUS). The long-term outcomes for these patients are described. A retrospective analysis of aMUS patients between 2009-2014 by a single surgeon for primary SUI was performed. All patients were evaluated preoperatively with urodynamics. Patient reported outcomes were collected via postal questionnaire using the ICIQ-UI short-form questionnaire, 7-point Global Impression of Improvement score, questions on pad usage, self-catheterisation, overactive bladder treatment and re-operation rates. Results included 31 patients (response rate 63.8%). The median age was 49 years and median BMI was 27. Twenty-seven per cent (27%) of patients had stress predominant mixed urinary incontinence pre-operatively. Median length of follow up was 8 years (5- 11); 60% of patients were dry and pad-free. Seventy-seven per cent (77%) found the surgery led to “much improvement” or “very much improvement” in quality of life. Thirteen per cent (13%) of patients reported a deterioration in quality of life. The median ICIQ-UI short form score was 5.5. 16.7% were taking medication and 1 patient received botulinum toxin therapy for overactive bladder symptoms. All these patients had mixed urinary incontinence on preoperative urodynamics. The re-operation rate was 13.3%. One patient was selfcatheterising. Three out of 31 (10%) had experienced pelvic pain, with 2 out of 31 (6%) experiencing dyspareunia. AMUS shows good long-term continence outcomes and is associated with low rates of de-novo overactive bladder symptoms and voiding dysfunction.
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| first_indexed | 2024-12-10T22:24:52Z |
| format | Article |
| id | doaj.art-0a2d4ef9b112478bba958a097d7c9f55 |
| institution | Directory Open Access Journal |
| issn | 1121-3086 2038-8314 |
| language | English |
| last_indexed | 2024-12-10T22:24:52Z |
| publishDate | 2021-09-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Urogynaecologia International Journal |
| spelling | doaj.art-0a2d4ef9b112478bba958a097d7c9f552022-12-22T01:31:13ZengPAGEPress PublicationsUrogynaecologia International Journal1121-30862038-83142021-09-0133110.4081/uij.2021.272205Autologous mid-urethral fascial sling for stress urinary incontinence: Long term outcomesTheo Malthouse0Ian Rudd1Chris Down2James Moore3East Sussex Healthcare NHS Trust, Eastbourne District General Hospital, Kings Dr, EastbourneEast Sussex Healthcare NHS Trust, Eastbourne District General Hospital, Kings Dr, EastbourneEast Sussex Healthcare NHS Trust, Eastbourne District General Hospital, Kings Dr, EastbourneEast Sussex Healthcare NHS Trust, Eastbourne District General Hospital, Kings Dr, Eastbourne There has been an increasing interest in mesh-free surgical options for Stress Urinary Incontinence (SUI). Traditionally rectus fascia autologous slings were placed at the bladder neck but more recently they are positioned at the mid-urethra (aMUS). The long-term outcomes for these patients are described. A retrospective analysis of aMUS patients between 2009-2014 by a single surgeon for primary SUI was performed. All patients were evaluated preoperatively with urodynamics. Patient reported outcomes were collected via postal questionnaire using the ICIQ-UI short-form questionnaire, 7-point Global Impression of Improvement score, questions on pad usage, self-catheterisation, overactive bladder treatment and re-operation rates. Results included 31 patients (response rate 63.8%). The median age was 49 years and median BMI was 27. Twenty-seven per cent (27%) of patients had stress predominant mixed urinary incontinence pre-operatively. Median length of follow up was 8 years (5- 11); 60% of patients were dry and pad-free. Seventy-seven per cent (77%) found the surgery led to “much improvement” or “very much improvement” in quality of life. Thirteen per cent (13%) of patients reported a deterioration in quality of life. The median ICIQ-UI short form score was 5.5. 16.7% were taking medication and 1 patient received botulinum toxin therapy for overactive bladder symptoms. All these patients had mixed urinary incontinence on preoperative urodynamics. The re-operation rate was 13.3%. One patient was selfcatheterising. Three out of 31 (10%) had experienced pelvic pain, with 2 out of 31 (6%) experiencing dyspareunia. AMUS shows good long-term continence outcomes and is associated with low rates of de-novo overactive bladder symptoms and voiding dysfunction. http://www.urogynaecologia.org/index.php/uij/article/view/272Stress urinary incontinenceautologous sling |
| spellingShingle | Theo Malthouse Ian Rudd Chris Down James Moore Autologous mid-urethral fascial sling for stress urinary incontinence: Long term outcomes Urogynaecologia International Journal Stress urinary incontinence autologous sling |
| title | Autologous mid-urethral fascial sling for stress urinary incontinence: Long term outcomes |
| title_full | Autologous mid-urethral fascial sling for stress urinary incontinence: Long term outcomes |
| title_fullStr | Autologous mid-urethral fascial sling for stress urinary incontinence: Long term outcomes |
| title_full_unstemmed | Autologous mid-urethral fascial sling for stress urinary incontinence: Long term outcomes |
| title_short | Autologous mid-urethral fascial sling for stress urinary incontinence: Long term outcomes |
| title_sort | autologous mid urethral fascial sling for stress urinary incontinence long term outcomes |
| topic | Stress urinary incontinence autologous sling |
| url | http://www.urogynaecologia.org/index.php/uij/article/view/272 |
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