It was reported in a journal article with title: repeat versus primary slings in patients with intrinsic sphincter deficiency.The aim of this retrospective cohort study is to evaluate the outcomes of repeat compared with primary slings in a cohort of patients with a urodynamic diagnosis of sui with isd.It was also our goal to determine any factors associated with an increased risk for sling failure, as well as any differences in outcomes between tension free trans-obturator and retropubic slings and tensioned pubovaginal slings.Between march 2003 to october 2010, a total of 637 female patients who underwent surgical treatment of sui with isd with a synthetic sling were included in the study.557 patients (mean age = 68.1±12.1 years; bmi = 27.4±5.1) had a primary sling placed, and 80 patients (mean age = 65.9±9.8 years; bmi = 26.9±4.8) underwent a repeat sling procedure for recurrent sui.Of the 637 slings, 132 (21 %) were tension-free mid-urethral trans-obturator slings (monarc), 174 (27 %) tension-free mid-urethral retropubic slings (anterior ivs and tvt (ethicon)), and 331 (52 %) tensioned pubovaginal slings placed at the bladder neck (prolene patch (ethicon) and i-stop).Reported complications included unsuccessful / not cured / failure (n=?) which required reintervention and underwent at least one in-office urethral bulking procedure during follow-up; subjective urgency/mui (n=?); de novo urgency (n=?); positive empty supine stress test (n=?); postoperative voiding dysfunction (n=?); bladder outlet obstruction (n=?) which required sling transection; infection of the synthetic sling or sutures (n=?) and underwent sling removal.In conclusion, in women with isd, repeat slings are associated with lower success rates compared with primary slings.Pubovaginal slings resulted in the highest success rate compared with both trans-obturator and retropubic slings.
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