AIMS: To compare the safety and efficacy of midurethral sling surgery for management of urinary stress incontinence in women over 80 years versus younger women. METHODS: 1225 consecutive women with urodynamic stress incontinence had a synthetic midurethral sling (955 retropubic, 270 transobturator) at our institution between 1999 and 2007. Ninety one percent (n = 1112) of the patients were interviewed via phone call with a structured questionnaire and were included in the analysis. The mean follow-up was 50 ± 24 months (range 12-114). Comparison between elderly (≥80 years, n = 96) and younger patients (<80 years, n = 1016) was performed. RESULTS: The overall subjective cure rate was 85% (elderly 81%, younger 85%, = 0.32). There was no significant difference in cure rate between retropubic and transobturator sling in the elderly group (82% vs. 79.3%, P = 0.75). The bladder perforation rate was similar between the two groups (3%). The hospitalization time was significantly longer in the elderly (1.6 ± 1.7 days vs. 0.7 ± 1.1 days, P<0.001). However, major perioperative complications were uncommon (1%). Of the patients who had an isolated sling procedure, 37% of the elderly and 9% of the young patients failed their 1st trial of void (P < 0.001). However, the long-term rate of voiding difficulty was similar between the two groups (elderly 8% vs. young 6%, P = 0.21). The rate of de novo urge incontinence was similar between the two groups (7%). CONCLUSION: Retropubic and transobturator slings in women older than 80 years are effective and safe but are associated with an increased risk of transient postoperative voiding difficulty.
AIMS: To compare the safety and efficacy of midurethral sling surgery for management of urinary stress incontinence in women over 80 years versus younger women. METHODS: 1225 consecutive women with urodynamic stress incontinence had a synthetic midurethral sling (955 retropubic, 270 transobturator) at our institution between 1999 and 2007. Ninety one percent (n = 1112) of the patients were interviewed via phone call with a structured questionnaire and were included in the analysis. The mean follow-up was 50 ± 24 months (range 12-114). Comparison between elderly (≥80 years, n = 96) and younger patients (<80 years, n = 1016) was performed. RESULTS: The overall subjective cure rate was 85% (elderly 81%, younger 85%, = 0.32). There was no significant difference in cure rate between retropubic and transobturator sling in the elderly group (82% vs. 79.3%, P = 0.75). The bladder perforation rate was similar between the two groups (3%). The hospitalization time was significantly longer in the elderly (1.6 ± 1.7 days vs. 0.7 ± 1.1 days, P<0.001). However, major perioperative complications were uncommon (1%). Of the patients who had an isolated sling procedure, 37% of the elderly and 9% of the young patients failed their 1st trial of void (P < 0.001). However, the long-term rate of voiding difficulty was similar between the two groups (elderly 8% vs. young 6%, P = 0.21). The rate of de novo urge incontinence was similar between the two groups (7%). CONCLUSION: Retropubic and transobturator slings in women older than 80 years are effective and safe but are associated with an increased risk of transient postoperative voiding difficulty.
Authors: Erinn M Myers; Catherine A Matthews; Andrea K Crane; AnnaMarie Connolly; Jennifer M Wu; Elizabeth J Geller Journal: Int Urogynecol J Date: 2017-03-11 Impact factor: 2.894
Authors: Joseph M Malek; David R Ellington; Victoria Jauk; Jeff M Szychowski; Alison M Parden; Holly E Richter Journal: Int Urogynecol J Date: 2014-12-16 Impact factor: 2.894
Authors: Philip Toozs-Hobson; Pooja Devani; Joseph Pick; Paul A Moran; Philip Assassa; Claire Burton Journal: Int Urogynecol J Date: 2016-03-18 Impact factor: 2.894
Authors: Rosa Maria Laterza; Ksenia Halpern; Daniela Ulrich; Alexandra Graf; Karl Tamussino; Wolfgang Umek Journal: PLoS One Date: 2018-08-16 Impact factor: 3.240