Do Periurethral Zuidex Injections Alter the Performance of Tension-Free Tapes in the Treatment of Stress Urinary Incontinence?

Abstract

Introduction: A proportion of patients with ongoing stress urinary incontinence (SUI) following periurethral injections may wish to consider further intervention in the form of a tension-free obturator tape. This study aims to establish whether the presence of periurethral Zuidex alters the operative procedure or affects the success rate of subsequent tension-free tape surgery. Patients and Methods: In a study of 200 consecutive female patients suffering from SUI managed with the urethral bulking agent Zuidex we reported a 62% success rate. Twenty-two of 76 patients who continued to suffer from SUI following periurethral Zuidex opted for further surgical intervention in the form of a tension-free tape. The median age of the patients was 63 years and the time between Zuidex treatment and tension-free tape insertion ranged from 5 to 31 months (median 6.8 months). Results: The presence of the bulking agent did not alter surgical technique or increase the complexity of tape insertion. Twenty of 22 (91%) women were pad free after tension-free tape and 2 patients reported an increase in lower tract symptoms (cystoscopy normal). Conclusions: In our experience the success of transobturator tape surgery for stress incontinence is not adversely affected by the previous use of periurethral injections of Zuidex.