How do urogynaecologists treat failed suburethral slings? Experience from the British Society of Urogynaecology database and literature review

Abstract

Midurethral urethral sling (MUS) procedures have high success and satisfaction rates. A small percentage of MUS operations will fail and most centres have limited experience of treating this outcome. The aim of this study was to review the British Society of Urogynaecology (BSUG) database for women who underwent repeat anti-incontinence surgery after failed MUS. A total of 313 repeat surgical procedures were identified. For any failed MUS, the commonest second surgical intervention was a repeat retropubic MUS and was used in 54% (170/313) of repeat procedures. Bladder neck injections were the second commonest repeat procedure (43/313 cases: 14%). TVT-Os were used as repeat surgery in 12% (38/313) and TOTs in 8% (25/313). Small numbers of colposuspensions (20/313, 6%) and Aldridge slings (6/313, 2%) were also used. A variety of different surgical treatments are used for failed MUSs. From the BSUG database review, the commonest second surgical intervention was a repeat retropubic MUS.

Keywords::

• Failed
• sling
• tape
• transobturator
• TVT

Declaration of interest: Mr Duckett has received sponsorship to attend meetings and perform research from Ethicon, Boston Scientific and American Medical Systems. Mr Moran has received sponsorship to attend meetings or lecturing honoraria from Ethicon, Bard, Boston Scientific and Astellas. The authors alone are responsible for the content and writing of the paper.