Does age affect the outcome of suburethral tape surgery? The importance of national registries in answering bigger questions.

Abstract

The objective of this article was to use the British Society of Urogynaecology (BSUG) database to assess the impact of age on success rates and insertion complications of suburethral tapes for primary procedures using the Patient Global Impression of Improvement (PGII) as the primary endpoint. We carried out a retrospective analysis of data at a national level (BSUG database) using PGII as the primary outcome measure. Secondary outcomes included improvement in stress incontinence and complications from surgery. All episodes of suburethral tapes on the database were extracted and analysis was by decade of life. A total of 7,600 cases were identified on the database, of which 757 were in women over 70years of age, with 119 in women over 80. Just over 80% of the cases on the database involved retropubic and just under 20% transobturator tapes. Short-term follow-up was available for 54% of the cases. The PGII remained high in all age groups, but did decrease slightly with age, with more than 90% of women under 50 scoring highly, which reduced to 70% in those over 80. Improvement in stress incontinence was globally high, with 98% scoring highly in the women aged under 50 and 85% in the 80+ group. This suggests that the suburethral tapes worked well in treating stress incontinence. Reassuringly, complications did not increase with age, although short-term voiding difficulties were higher with increasing age. Contributing to national databases gives useful information that may be difficult to ascertain from RCTs. Suburethral tapes appear to have good efficacy and low complications with increasing age.