Outcomes of minimally invasive suburethral slings with and without concomitant pelvic organ prolapse surgery

Abstract

Objective: To assess subjective outcomes among patients who underwent minimally invasive suburethral sling (MIS) surgery for stress urinary incontinence with or without concurrent pelvic organ prolapse (POP) surgery.

Methods: In a prospective study between 2002 and 2010, patients who underwent MIS surgery with or without concomitant POP surgery at Croydon University Hospital, UK, completed the ICIQ-FLUTS and ICIQ-LUTSqol questionnaires on lower urinary tract symptoms and quality of life before and 12 months after surgery.

Results: Overall, 203 patients underwent MIS surgery alone and 91 underwent concomitant POP and MIS surgery. At 12 months, the response rate was 64.3%. Before surgery, there was no significant difference between the groups in any domain of ICIQ-FLUTS and ICIQ-LUTSqol, except for in the incontinence domain of ICIQ-FLUTS, for which scores were significantly worse in the MIS group (P=0.018). All domains of ICIQ-FLUTS and ICIQ-LUTSqol had improved after 1 year in both groups, except for the voiding domain of the ICIQ-FLUTS in the MIS group (P=0.054). After surgery, there was no difference between the groups in any domain (P>0.05). Complication rates were low in both groups.

Conclusion: MIS with concomitant POP surgery is as safe and effective as MIS surgery alone.

Keywords: Concomitant prolapse surgery; Minimally invasive suburethral sling; Tension-free vaginal tapes; Urinary incontinence.