Does concomitant prolapse repair at the time of midurethral sling affect recurrent rates of incontinence?

Introduction And Hypothesis: We compared outcomes after midurethral sling (MUS) with and without concomitant repair for prolapse.

Methods: Women who underwent MUS with or without concomitant repair for prolapse completed a follow-up survey. Outcomes were assessed with validated questionnaires and medical record review. Kaplan-Meier, Cox proportional hazards regression, and logistic regression models were used for analysis.

Results: Of 317 women, 281 (89%) responded to the survey. During a median follow-up of 2.7 years, survival free of "any" incontinence (Incontinence Severity Index score, >0) was similar in both groups (adjusted hazard ratio, 1.07; P = 0.77). Women with concomitant repair for advanced prolapse tended to be more bothered by frequent urination (adjusted odds ratio, 1.78; P = 0.08) and more likely to require urethrolysis (odds ratio, 6.11; P = 0.04) than those without concomitant pelvic floor repair.

Conclusions: Prolapse repairs concomitant with MUS did not affect incontinence recurrence. However, repairs may cause increased lower urinary tract symptoms.