From: Repeat midurethral sling treatment for prior midurethral sling failure
Study | Sample (n) | Age (years) or mean, and range or SD | Prior surgery | Repeat surgery | Time to repeat surgery (months) or mean, and range or SD | UD finding before repeat surgery | Outcomes/conclusions |
---|---|---|---|---|---|---|---|
Riachi et al. [19] | 2 | 64 | MMK urethropexy, allograft fascial sling, TVT | TVT (previous TVT tape was not identified) | 8 | Q-tip = 40°, UD confirmed SUI | Remained continence on 13-month follow-up |
71 | Autologous fascial sling, TVT | TVT (previous TVT tape was found) | 9 | UD confirmed SUI with ISD | SUI completely resolved on 6-month follow-up | ||
Villet et al. [10] | 2 of 3 | 54 | TVT | TVT(previous TVT was not identified) | 18 | Patient gained 6 kg; positive stress test with urethral hypermobility | At 12 months follow-up, the patient is still continent |
73 | Burch colpopexy, TVT | TVT (previous TVT tape was found) | 8 | No mention may be due to persistent SUI | At 4 months follow-up, the patient is continent | ||
Eandi et al. [13] | 10 | 65.1 (range 43–80) | TVT 5 cases, TOT 5 cases | All TVT | 14 (3–32) | VLPP (cmH2O) | Follow-up at a mean of 16 months (range 6–33); 7 patients (70%) reported complete or improved continence and quality of life, 3 patients failed; second TVT may be a viable option after failure of initial MUS procedure |
<60, 3 cases | |||||||
60–100, 4 cases | |||||||
>100, 3 cases | |||||||
Moore et al. [14] | 5 | 66.3 (range 56–76) | TOT (initial TOT in 4 cases, and 1 with h/o failed Burch, combined pelvic reconstruction in 4 cases) | All TVT | 3 (1–7) | Diagnosis of ISD for 5 patients (ISD, MUCP <20 cmH2O or VLPP <65 cmH2O) | All five patients successfully treated with repeat TVT; TVT may be more appropriate treating patients with ISD because TVT offered more acute retropubic angle |
Tsivian et al. [15] | 12 | 64.3 (range 47–80) | TVT 9, TOT 1, IVS 2 | TVT 5, TOT 3, IVS 4 | 21.4 (1–48) | 4 cases of VLPP <60 cmH2O, 8 cases of mobile urethra | 11 patients (91.7%) achieved continence after repeat MUS (mean follow-up of 23.2, range 14–44); the choice of MUS procedure is a matter of surgeon’s preference; the timing of repeat MUS is no delay |
Lee et al. [16] | 29 | 54.1 ± 10.8 (SD) | Retropubic route—TVT 17 | Retropubic route—TVT 13 | 20.0 ± 16.9 | In patients with UD examination, increased VLPP (mean ± SD, 55.4 ± 22.6 cmH2O) after initial MUS procedure (35.6 ± 12.9) | Total cure rates: 22/29 (75.9%) at mean follow-up of 13 months; cure rates: retropubic (12/13, 92.3%) vs. transobturator (10/16, 62.5%) with p = 0.0089; transobturator approach: TVT-O (6/8, 75%) vs. TOT (4/8, 50%) with significant p = 0.048 |
Transobturator route—TOT 6, TVT-O 6 | Transobturator route—TOT 8, TVT-O 8 | ||||||
Palva and Nilsson [20] | 20 | 61 ± 9 (SD) | All TVT (tape material—Teflon 3, Mersilene 5, polypropylene 13) | All TVT (Gynecare, J&J) | 57 ± 32 | Stress test (−) in 15 patients, pad test was negative in 13 patients; both stress and pad test (−) in 11 patients | 5 years follow-up of repeat TVT revealed a 75% (15/20) objective cure or improvement rate; inadequate tape material, inadequate surgical technique, patients’ medical condition, and unrecognized reasons may cause the failed primary TVT |
Van Baelen and Delaere [22] | 21 | 56 (range 33–77) | TVT 5, TOT 16 | All TOT | 18 | Urodynamic study performed, but no mention of the report | Failure rate was 30% in repeat TOT surgery; the transobturator approach seems to show poorer outcomes than the retropubic approach in repeat sling surgery |