Phil Hyun Song1, Eun Sang Yoo. 1. Department of Urology, College of Medicine, Yeungnam University, School of Medicine, Kyungpook National University, Daegu, Korea.
Abstract
OBJECTIVE: To evaluate the outcomes of sling transection in treating obstructive voiding symptoms after transobturator sling surgery and the recurrence rates of stress urinary incontinence after 5-year follow-up. MATERIAL AND METHODS: Between January 2004 and March 2006, we retrospectively reviewed 461 patients who underwent the transobturator sling procedure. Of 461 patients, 28 patients (6.1%) underwent transection of suburethral sling tape under local anesthesia and followed up for at least 5 years after sling transection. We analyzed the overall success rates and recurrence rates of stress urinary incontinence using uroflowmetry with post-void residual measurement, 5 cm visual analogue scale for assessment of postoperative goal achievement, obstructive domain of International Prostate Symptom Score (IPSS) and quality of life (QoL). RESULTS: Mean maximal urinary flow and post-void residual were 21.8 ± 4.1 mL/s and 38.8 ± 3.4 mL at 5-year follow-up after sling transection. The mean 5 cm visual analogue scale, O-IPSS and IPSS QoL scores were 4.3 ± 1.4, 2.8 ± 2.9, and 2.3 ± 1.9, respectively, at 5-year follow-up. The objective and subjective success rates were 100% and 68%. Six patients (24%) redeveloped stress urinary incontinence. CONCLUSION: According to our long-term (≥ 5 years) follow-up results, the transection of suburethral sling tape is a simple and effective method to treat obstructive symptoms after the transobturator sling procedure.
OBJECTIVE: To evaluate the outcomes of sling transection in treating obstructive voiding symptoms after transobturator sling surgery and the recurrence rates of stress urinary incontinence after 5-year follow-up. MATERIAL AND METHODS: Between January 2004 and March 2006, we retrospectively reviewed 461 patients who underwent the transobturator sling procedure. Of 461 patients, 28 patients (6.1%) underwent transection of suburethral sling tape under local anesthesia and followed up for at least 5 years after sling transection. We analyzed the overall success rates and recurrence rates of stress urinary incontinence using uroflowmetry with post-void residual measurement, 5 cm visual analogue scale for assessment of postoperative goal achievement, obstructive domain of International Prostate Symptom Score (IPSS) and quality of life (QoL). RESULTS: Mean maximal urinary flow and post-void residual were 21.8 ± 4.1 mL/s and 38.8 ± 3.4 mL at 5-year follow-up after sling transection. The mean 5 cm visual analogue scale, O-IPSS and IPSS QoL scores were 4.3 ± 1.4, 2.8 ± 2.9, and 2.3 ± 1.9, respectively, at 5-year follow-up. The objective and subjective success rates were 100% and 68%. Six patients (24%) redeveloped stress urinary incontinence. CONCLUSION: According to our long-term (≥ 5 years) follow-up results, the transection of suburethral sling tape is a simple and effective method to treat obstructive symptoms after the transobturator sling procedure.