Portal de Periódicos da CAPES

Risk factors for stress urinary incontinence recurrence after single‐incision sling

2018; Wiley; Volume: 37; Issue: 5 Linguagem: Inglês

10.1002/nau.23487

1520-6777

Stefania Palmieri, Matteo Frigerio, Federico Spelzini, Stefano Manodoro, Rodolfo Milani,

Urinary Bladder and Prostate Research

Aims The aim of the study was to identify in a pure stress urinary incontinence (SUI) population risk factors for recurrence after single‐incision slings (SIS). Methods This retrospective study analyzed women with complaints of SUI symptoms and urodynamically proven SUI. Exclusion criteria were recurrent SUI, overactive bladder syndrome/detrusor overactivity, preoperative postvoid residual >100 mL, reduced urethral mobility (<10° at the Q‐tip test), concomitant anterior prolapse >I stage and previous history of radical pelvic surgery. Objective cure rate was assessed with stress test. Results A total of 192 patients were analyzed. Objective cure rate was obtained in 86.5% of patients. According to univariate analysis, recurrences had higher prevalence of severe ICIQ‐SF score (≥18 points), higher prevalence of reduced urethral mobility (Qtip ≤30°), higher prevalence of low detrusor pressures during voiding phase (opening pressure <15 cmH 2 O, pressure at maximum flow <20 cmH 2 O, closing pressure <15 cmH 2 O), and higher prevalence of postoperative complications According to multivariate analysis ICIQ‐SF score ≥18 points ( P = 0.02; OR = 2.7) and detrusor pressure at maximum flow <20 cmH 2 O ( P < 0.01; OR = 3.6) resulted as independent risk factors for SUI recurrence (Table 3). A trend was found for urethral mobility ≤30° ( P = 0.07; OR = 2.2). Conclusions Our study identifies SUI severity expressed with ICIQ‐SF scores and low detrusor pressure at maximum flow as independent risk factors for SUI recurrence after SIS implantation while only a trend was found for reduced urethral mobility. Therefore, preoperative assessment of symptoms and urodynamics evaluation may play a key role in improving preoperative counseling and tailoring surgical treatment.