Urological Science

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 29  |  Issue : 4  |  Page : 198--201

Sling incision is not always sufficient: A case series


Philippe E Zimmern1, Himanshu Aggarwal2, Feras Alhalabi1 
1 The University of Texas Southwestern Medical Center, Dallas, TX, USA
2 Baptist Medicine Center South, Montgomery, AL, USA

Correspondence Address:
Philippe E Zimmern
The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX
USA

Objectives: To review various erroneous diagnoses assigned to symptomatic women after MUS incision, and report our outcomes after MUS excision in these women. Materials and Methods: Following IRB approval, a retrospective review of a prospectively collected MUS removal database was performed for non-neurogenic women who presented with continued LUTS despite a prior sling incision. Data reviewed by a neutral investigator not involved in patient care included demographics, presenting symptomatology, and outcomes after sub-urethral sling excision. Results: From 2006-2015, 18 patients were identified. Mean age was 55 + 12 years. Median time from initial placement to sling incision was 12 (range 1-108) months. Following sling incision, residual LUTS were treated with various therapies but without LUTS resolution. Indications for sling excision were obstruction (3), obstruction and pain (2), persistent vaginal pain/dyspareunia (9), recurrent vaginal exposure/dyspareunia (2), worsening urgency incontinence (1) and mixed urinary incontinence (1). Median time from sling incision to sling excision was 55 (range 5-146) months. Median follow-up after MUS excision was 12 months (range 6-45 months). Obstruction (5) and exposure (2) were all cured. Vaginal pain and dyspareunia improved in 8 of 11 women and UUI improved in one. Three women had persistent SUI and 1 developed recurrent SUI. Two women were treated satisfactorily with bulking agents, one with fascial sling and one with bulking agent followed by a fascial sling. Conclusions: Sling incision may not always resolve LUTS. In a subset of women, sling excision may eventually be needed, with variable outcomes.


How to cite this article:
Zimmern PE, Aggarwal H, Alhalabi F. Sling incision is not always sufficient: A case series.Urol Sci 2018;29:198-201


How to cite this URL:
Zimmern PE, Aggarwal H, Alhalabi F. Sling incision is not always sufficient: A case series. Urol Sci [serial online] 2018 [cited 2021 Jul 30 ];29:198-201
Available from: https://www.e-urol-sci.com/article.asp?issn=1879-5226;year=2018;volume=29;issue=4;spage=198;epage=201;aulast=Zimmern;type=0