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Reoperation Rate Down With Retropubic Sling for Incontinence

Cumulative incidence of reoperation significantly lower versus transobturator sling

TUESDAY, July 23, 2019 (HealthDay News) — For women with recurrent stress urinary incontinence (SUI), the cumulative incidence of reoperation is significantly lower with treatment with a retropubic sling versus a transobturator sling, according to a study published online July 9 in Obstetrics & Gynecology.

Emanuel C. Trabuco, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues identified 1,881 women who underwent a sling procedure for primary SUI between 2002 and 2012 to compare reoperation rates after retropubic and transobturator sling procedures (1,551 and 330, respectively). Results were included from a covariate-matched cohort of 570 retropubic slings and 317 transobturator slings.

The researchers found that the risk for reoperation for recurrent SUI was increased for women undergoing a transobturator sling procedure versus a retropubic sling procedure (hazard ratio, 2.42). By eight years, the cumulative incidence of reoperation was 5.2 and 11.2 percent in the retropubic and transobturator groups, respectively. Compared with women in the transobturator group, those in the retropubic group had a significantly higher rate of intraoperative complications (13.7 versus 4.7 percent); most of this difference was due to bladder perforation (7.0 versus 0.6 percent). By five years, the cumulative incidence of sling revision for urinary retention plateaued at 3.2 and 0.4 percent for the retropubic and transobturator groups, respectively.

“This finding should help providers counsel women presenting for surgical treatment of SUI,” the authors write.

Two authors disclosed financial ties to UpToDate and Elsevier.

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