Defining success following sling surgery: association of satisfaction with patient reported outcomes.

Aims: The assessment of incontinence therapies is complicated by the variety of patient reported outcomes (PRO) measures used in research protocol. Patient satisfaction may be one of the most relevant albeit complex PRO measures and is a function of many related variables. We sought to assess the relationship between patient satisfaction and other PRO.

Bone-anchored suburethral sling: surgical technique and outcomes.

The gold standard treatment for stress urinary incontinence (SUI) is the autologous rectus fascia pubovaginal sling. Although successful, it is associated with increased morbidity related to the graft harvest. Because of this, less invasive techniques were developed, including the retropubic and trans-obturator midurethral sling and the bone-anchored sling (BAS).

Bladder sensation measures and overactive bladder.

Purpose: We performed a prospective multicomponent study to determine whether subjective and objective bladder sensation instruments may provide data on sensory dysfunction in patients with overactive bladder.

Materials And Methods: We evaluated 70 prospectively enrolled patients with urodynamics and questionnaires on validated urgency (Urgency Perception Score), general overactive bladder (Urogenital Distress Inventory) and quality of life (Incontinence Impact Questionnaire). We first sought a correlation between sensory specific (Urgency Perception Score) and quality of life questionnaire scores.

Outcomes following mid-urethral sling placement in patients with intrinsic sphincteric deficiency: comparison of Sparc and Monarc slings.

Purpose: The treatment of patients with intrinsic sphincteric deficiency (ISD) remains difficult. It is theorized that differing vectors of support provided by retropubic versus transobturator mid-urethral sling routes may affect outcomes. We sought to compare outcomes of patients undergoing SPARC versus MONARC sling types in patients with Valsalva leak point pressures (VLPPs) below 60 cm H2O.

Outcomes following sling surgery: importance of definition of success.

Purpose: The assessment of incontinence therapies is complicated by the diverse outcomes instruments and definitions of success used by investigators. We defined this effect by using varied definitions of success to perform outcomes analysis following sling placement.

Materials And Methods: A retrospective review of patients undergoing SPARC (314) and autologous rectus pubovaginal sling (127) placement was performed, with 204 patients with the SPARC and 67 with pubovaginal sling completing questionnaire surveillance with the minimum 12-month followup.

Transvaginal bone-anchored sling for the treatment of female stress urinary incontinence: effect of Valsalva leak point pressure and prior pelvic surgery on outcomes.

The effect of lower Valsalva leak point pressure (VLPP) and previous pelvic surgery on outcomes following sling surgery is controversial. We assessed outcomes following bone-anchored sling (BAS) placement in patients with intrinsic sphincteric deficiency (ISD) and previous pelvic surgery. A retrospective review of 149 patients undergoing BAS placement was performed.

Complications of grafts used in female pelvic floor reconstruction: Mesh erosion and extrusion.

Introduction: Various grafts have been used in the treatment of urinary incontinence and pelvic prolapse. Autologous materials such as muscle and fascia were first utilized to provide additional anatomic support to the periurethral and pelvic tissues; however, attempts to minimize the invasiveness of the procedures have led to the use of synthetic materials. Complications such as infection and erosion or extrusion associated with these materials may be troublesome to manage.

High rate of vaginal erosions associated with the mentor ObTape.

Purpose: The transobturator tape method is a newer surgical technique for the treatment of stress urinary incontinence. Limited data exist related to complications with this approach or the types of mesh products used. We report our experience with vaginal erosions associated with the Mentor ObTape and American Medical Systems Monarc transobturator slings.