PII-03 5-YEAR OUTCOMES AFTER RETROPUBIC AND TRANSOBTURATOR MIDURETHRAL SLING

Abstract

You have accessJournal of UrologyPlenary Session II: Best Abstracts1 Apr 2014PII-03 5-YEAR OUTCOMES AFTER RETROPUBIC AND TRANSOBTURATOR MIDURETHRAL SLING Kimberly Kenton, Anne Stoddard, Halina Zyczynski, Leslie Rickey, Clifford Wai, Mike Albo, Peggy Norton, Larry Sirls, Stephen Kraus, and Holly Richter Kimberly KentonKimberly Kenton More articles by this author , Anne StoddardAnne Stoddard More articles by this author , Halina ZyczynskiHalina Zyczynski More articles by this author , Leslie RickeyLeslie Rickey More articles by this author , Clifford WaiClifford Wai More articles by this author , Mike AlboMike Albo More articles by this author , Peggy NortonPeggy Norton More articles by this author , Larry SirlsLarry Sirls More articles by this author , Stephen KrausStephen Kraus More articles by this author , and Holly RichterHolly Richter More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1144AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives To compare 5-year continence rates, complication rates and pelvic floor outcomes after retropubic (RMUS) and transobturator (TMUS) midurethral slings. Methods Women in Trial of Midurethral Slings (TOMUS) who did not undergo surgical retreatment for SUI were approached for extended follow-up (E-TOMUS). Participants completed annual in-person visits, including pelvic examination and QOL questionnaires. Treatment success was defined as no retreatment for SUI and no self-reported SUI symptoms on MESA. Time to failure and log rank test assessed differences in success between treatment arms. Results 404 of 597 (68%) of TOMUS subjects participated in E-TOMUS. All women randomized in TOMUS were included in Kaplan Meier time to event analysis (Figure 1). There was no difference in success rates between RMUS and TMUS groups over time (p=0.09). Treatment success for RMUS is 7.9% higher than TMUS (51.3% vs 43.4%, 95% CI -1.4, 17.2) and did not meet criteria for equivalence (Figure 2). There were no differences in the proportion of women who experienced complications (p=0.17) including mesh erosions requiring surgery, RMUS (3) and TMUS (4). Urinary symptoms increased and QOL declined (as measured by UDI and IIQ) significantly over time (p<0.001) with TMUS having better urinary QOL scores than RMUS (p=0.02). Sexual function significantly declined over time in both groups (p=0.004), but more so in the RMUS group (p=0.001). A higher percentage of women in the TMUS group report being ‘very much better’ or ‘much better’ than in the RMUS group (88% vs. 77%, p=.01). Overall satisfaction was similar between RMUS and TMUS at 5 years (78.9%, RMUS vs 84.7%, TMUS, p=.15); however, proportion who were completely or mostly satisfied decreased significantly over time in both groups (from 93% at 6 mo to 79% at 5 yr in RMUS and 92% at 6 mo to 85% at 5 yr in TMUS, p= 0.0001). Conclusions 5-year- continence rates declined after RMUS & TMUS, and did not meet pre-specified criteria for equivalence; however, satisfaction remains high. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e493 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Kimberly Kenton More articles by this author Anne Stoddard More articles by this author Halina Zyczynski More articles by this author Leslie Rickey More articles by this author Clifford Wai More articles by this author Mike Albo More articles by this author Peggy Norton More articles by this author Larry Sirls More articles by this author Stephen Kraus More articles by this author Holly Richter More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...