Five-year Outcomes of the Transection of Synthetic Suburethral Sling Tape for Treating Obstructive Voiding Symptoms After Transobturator Sling Surgery

Abstract

To evaluate the outcomes of sling transection in treating obstructive voiding symptoms after transobturator sling surgery and the recurrence rates of stress urinary incontinence after 5-year follow-up. Between January 2004 and March 2006, we retrospectively reviewed 461 patients who underwent the transobturator sling procedure. Of 461 patients, 28 patients (6.1%) underwent transection of suburethral sling tape under local anesthesia and followed up for at least 5 years after sling transection. We analyzed the overall success rates and recurrence rates of stress urinary incontinence using uroflowmetry with post-void residual measurement, 5 cm visual analogue scale for assessment of postoperative goal achievement, obstructive domain of International Prostate Symptom Score (IPSS) and quality of life (QoL). Mean maximal urinary flow and post-void residual were 21.8 ± 4.1 mL/s and 38.8 ± 3.4 mL at 5-year follow-up after sling transection. The mean 5 cm visual analogue scale, O-IPSS and IPSS QoL scores were 4.3 ± 1.4, 2.8 ± 2.9, and 2.3 ± 1.9, respectively, at 5-year follow-up. The objective and subjective success rates were 100% and 68%. Six patients (24%) redeveloped stress urinary incontinence. According to our long-term (≥ 5 years) follow-up results, the transection of suburethral sling tape is a simple and effective method to treat obstructive symptoms after the transobturator sling procedure.