Objective: To determine the functional outcomes after synthetic sling revision surgery performed for voiding dysfunction. Study design: A retrospective review of 63 women who underwent surgical revision of a synthetic sling (SS) over an 11 year period between 2000 and 2010 inclusive, for the treatment of voiding dysfunction. Voiding dysfunction was defined as a persistently raised post-void residual of >150 ml. Patient review included demographics, a comprehensive medical history, all surgical reports and a detailed proforma with details of lower urinary tract symptoms, physical findings and bladder diaries. Variables were compared between methods of sling revision using the Fisher exact test (Freeman-Halton extension) with a 2 by 3 contingency table. Statistical significance is defined as P = 0.05. Results: Sixty-three women underwent SS revision for voiding dysfunction with an overall success rate of 87 . Three types of surgical revision were performed; simple SS division (46/63, 73 ), partial excision of SS material (13/63, 21 ) and either division or excision but with a concomitant procedure to prevent recurrent SUI (4/63, 6 ). Persistent voiding dysfunction following revision in each of the three groups was 5/46 (10.9 ), 1/13 (7.7 ) and 2/4 (50 ) respectively (P = 0.09). Subsequent surgery for recurrent SUI in each of the groups was 1/46 (2.2 ), 3/13 (23.1 ) and 0/4 (0 ) respectively (P = 0.04). Conclusions: Surgical revision of a SS is an effective treatment for postoperative voiding dysfunction. Both simple division and partial excision of the SS are successful, but simple division carries a lower risk of recurrent SUI. A concomitant SUI procedure at the time of revision may prevent recurrence but may increase the risk of persistent voiding dysfunction.
|Pages (from-to)||113 - 116|
|Number of pages||4|
|Journal||European Journal of Obstetrics & Gynecology and Reproductive Biology|
|Publication status||Published - 2012|