https://doi.org/10.4081/uij.2021.272
Autologous mid-urethral fascial sling for stress urinary incontinence: Long term outcomes
Submitted: 10 May 2021
Accepted: 20 July 2021
Published: 17 September 2021
Accepted: 20 July 2021
Abstract Views: 1663
PDF: 189
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
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.
NICE. NICE - 1.5 Surgical management of stres surinary incontinence. 2019. Accessed: 30 December 2019.Available from: https://www.nice.org.uk/guidance/ng123/chapter/recommendations#autologous-rectus-fascial-sling
Aldridge A. Transplantation of fascia for the relief of urinary stress incontinence. Am J Obstet Gynecol 1942;44;398-441.
DOI: https://doi.org/10.1016/S0002-9378(42)90477-0
Ulmstem U, Henriksen L, Johnson P, Varhos G. An ambulatory surgical procedure under local anaesthetic for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 1996;7:81.
DOI: https://doi.org/10.1007/BF01902378
McGuire E, Lytton B. Pubovaginal sling procedure for stress incontinence. J Urol 1978;119:82-4.
DOI: https://doi.org/10.1016/S0022-5347(17)57390-5
Malde S, Moore J. Autologous mid-urethral sling for stress urinary incontinence: Preliminary results and description of a contemporary technique. J Clin Urol 2016;9:40-47.
DOI: https://doi.org/10.1177/2051415815589900
Brubaker L, Richter H, Norton P, et al. Five year continence rates, satisfaction and adverse events of burch urethropexy and fascial sling surgery for urinary incontinence. J Urol 2012;187:1324-30.
DOI: https://doi.org/10.1016/j.juro.2011.11.087
Khan Z, Nambiar A, Morley R, et al. Long-term follow-up of a multicentre randomised controlled trial comparing tension-free vaginal tape, xenograft and autologous fascial slings for the treatment of stress urinary incontinence in women. Br J Urol Int 2015;115:968-77.
DOI: https://doi.org/10.1111/bju.12851
Cubuk F, Yanaral A, Sahan A, et al. Modified autologous transobturator tape surgery - a prospective comparison with transobturator tape surgery. Urology 2020;146:72-8.
DOI: https://doi.org/10.1016/j.urology.2020.09.018
Yalcin I, Bump RC. Validation of two global impression questionnaires for incontinence. Am J Obst Gynecol 2003;1:98-101.
DOI: https://doi.org/10.1067/mob.2003.379
Ostergard D. Primary slings for everyone with genuine stress incontinence? The argument against. Int Urogynecol J Pelvic Floor Dysfunct 1997;8:321-2.
DOI: https://doi.org/10.1007/BF02765588
Nilsson C, Palva K, Aarnio R, et al. Seventeen years’ follow-up of the tension-free vaginal tape procedure for female stress urinary incontinence. Int Urogynecol J 2013;24:1265-9.
DOI: https://doi.org/10.1007/s00192-013-2090-2
Lim R, Long Liong M, Lau Y, Yuen K. Validity, reliability, and responsiveness of the ICIQ‐UI SF and ICIQ‐LUTSqol in the Malaysian population. Neurourol Urodynam 2015;36:2.
DOI: https://doi.org/10.1002/nau.22950
Nystrom E, Sjostrom M, Stenlund H, Samuelsson E. ICIQ symptom and quality of life instruments measure clinically relevant improvements in women with stress urinary incontinence. Neurourol Urodynam 2015;34:747-51.
DOI: https://doi.org/10.1002/nau.22657
Mitsui T, Tanaka H, Moriya K, et al. Clinical and urodynamic outcomes of pubovaginal sling procedure with autologous rectus fascia for stress urinary incontinence. Int J Urol 2007;14:1076-9.
DOI: https://doi.org/10.1111/j.1442-2042.2007.01909.x
Albo M, Richter H, Brubaker L, et al. Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med 2007;24:2143-55.
DOI: https://doi.org/10.1056/NEJMoa070416
Osman N, Hillary C, Mangera A, et al. The midurethral fascial “sling on a string”: an alternative to midurethral synthetic tapes in the era of mesh complications. European Urology 2018;74:191-6.
DOI: https://doi.org/10.1016/j.eururo.2018.04.031
Zycznski H, Albo M, Goldman H, et al. Change in overactive bladder symptoms after surgery for stress urinary incontinence in women. Obstet Gynecol 2015;126:423-30.
DOI: https://doi.org/10.1097/AOG.0000000000000929
Jeon M, Jung H, Chung S, et al. Comparison of the treatment outcome of pubovaginal sling, tension-free vaginal tape, and transobturator tape for stress urinary incontinence with intrinsic sphincter deficiency. Am J Obstet Gynecol 2008;199:1-4.
DOI: https://doi.org/10.1016/j.ajog.2007.11.060
Flisser AJ, Blaivas JG. Outcome of urethral reconstructive surgery in a series of 74 women. J Urol 2003;169:2246-9.
DOI: https://doi.org/10.1097/01.ju.0000061763.88247.16
Morgan T, Westney O, McGuire E. Pubovaginal sling: 4-year outcome analysis and quality of life assessment. J Urol 2000;163:1845-8.
DOI: https://doi.org/10.1016/S0022-5347(05)67557-X
Morgan D, Dunn R, Fenner D. Comparative analysis of urinary incontinence severity after autologous fascia pubovaginal sling, pubovaginal sling and tension-free vaginal tape. J Urol 2007;177:604-8.
DOI: https://doi.org/10.1016/j.juro.2006.09.062
Ayorinde AA, Bhattacharya S, Druce KL, Jones GT, Macfarlane GJ. Chronic pelvic pain in women of reproductive and post-reproductive age: a population-based study. Eur J Pain 2017;21:445-55.
DOI: https://doi.org/10.1002/ejp.938
Zondervan KT, Yudkin P, Vessey M, et al. The prevalence of chronic pelvic pain in women in the United Kingdom: a systematic review. Br J Obstet Gynecol 1998;105:93-9.
DOI: https://doi.org/10.1111/j.1471-0528.1998.tb09357.x
Çubuk A, Şahan A, Özkaptan O, et al. Impact of autologous transobturator sling surgery on female sexual function: a comparative study with mesh used mid-urethral sling surgeries. Urol Int 2021. doi: 10.1159/000514415.
DOI: https://doi.org/10.1159/000514415
Lifford KL, Townsend MK, Curhan GC, et al. The epidemiology of urinary incontinence in older women: incidence, progression, and remission. J Am Geriatr Soc 2008;56:1191-8.
DOI: https://doi.org/10.1111/j.1532-5415.2008.01747.x
Tennstedt SL, Litman HJ, Zimmern P, et al. Urinary Incontinence Treatment Network. Quality of life after surgery for stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2008;19:1631-8.
DOI: https://doi.org/10.1007/s00192-008-0700-1
How to Cite
Malthouse, T., Rudd, I., Down, C., & Moore, J. (2021). Autologous mid-urethral fascial sling for stress urinary incontinence: Long term outcomes. Urogynaecologia, 33(1). https://doi.org/10.4081/uij.2021.272
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
An Open Access Publication is one that meets the following two conditions:
- the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.
- a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
Similar Articles
- P. Liguori, R. Ripoli, REPAIR OF POSTERIOR VAGINAL WALL DEFECTS WITH PELVICOL™ IMPLANT ANCHORED TO ILIOCOCCYGEUS , Urogynaecologia: Vol. 20 No. 1 (2006)
- V. Leanza, F. Genovese, M. Bologna, Laparoscopic application of Mesh in the treatment of pelvic floor disorders: a review of the literature , Urogynaecologia: Vol. 21 No. 1 (2007)
- R. Baccichet, C. Braghin, A. Azzena, MINIMALLY-INVASIVE TRANSOBTURATOR CORRECTION OF CYSTOCELE , Urogynaecologia: Vol. 20 No. 3 (2006)
- Shoeb Alahmad, Rawaa AlKayali, Lubana Alkhoder, Gihad Allugamie, The effectiveness of intravesical oxybutynin in the management of overactive bladder: a clinical study , Urogynaecologia: Vol. 36 No. 1 (2024)
- F. BERNASCONI, G. PISANI, S. ARIENTI, B. VERONESE, S. PITTALIS, M. CONTI, M. TASSI, S. GELOSA, A. BIELLA, C. CERRI, Uro-rehabilitation and effort urinary incontinence: medium-term results and analysis of the failure risk factors. , Urogynaecologia: Vol. 15 No. 2 (2001)
- M. CERVIGNI, G. ORTICELLI, M. BOLOGNA, F. NATALE, E. SALVATORI, G. DI LORETO, P. DIONISIO, SINGLE-DOSE PRULIFLOXACIN VERSUS SINGLE-DOSE PEFLOXACIN IN THE TREATMENT OF ACUTE UNCOMPLICATED URINARY TRACT INFECTION IN WOMEN , Urogynaecologia: Vol. 18 No. 3 (2004)
- M. CERVIGNI, G. ORTICELLI, M. BOLOGNA, F. NATALE, E. SALVATORI, G. DI LORETO, P. DIONISIO, SINGLE-DOSE PRULIFLOXACIN VERSUS SINGLE-DOSE PEFLOXACIN IN THE TREATMENT OF ACUTE UNCOMPLICATED URINARY TRACT INFECTION IN WOMEN , Urogynaecologia: Vol. 17 No. 2 (2003)
- Bambang Sasongko Noegroho, Akhmad Mustafa, Predictive factor for successful retrograde ureteral stent insertion in obstructive uropathy due to advanced cervical cancer , Urogynaecologia: Vol. 31 No. 1 (2019)
- Zhuoran Chen, Lucy Bates, Nevine Te West, Kate H. Moore, A 9-year audit of the efficacy of diathermy for cystitis cystica , Urogynaecologia: Vol. 31 No. 1 (2019)
- Kristina Crafoord, Jan Brynhildsen, Olof Hallböök, Preben Kjølhede, Pelvic organ prolapse and anorectal manometry: a prospective study , Urogynaecologia: Vol. 26 No. 1 (2012)
You may also start an advanced similarity search for this article.