Evaluation of Clinical Outcome and Risk Factors for Failure of Single-incision Midurethral Short Tape Procedure (Solyx Tape) for Stress Urinary Incontinence

doi:10.1016/j.jmig.2018.07.013

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Title:	Evaluation of Clinical Outcome and Risk Factors for Failure of Single-incision Midurethral Short Tape Procedure (Solyx Tape) for Stress Urinary Incontinence
Authors:	Lo, Tsia-Shu Shailaja, Nagashu Chua, Sandy Tseng, Ling-Hong Kao, Chuan-Chi Ming-Ping Wu(吳銘斌)
Contributors:	Chang Gung Mem Hosp, Keelung Med Ctr, Dept Obstet & Gynecol Chang Gung Mem Hosp, Dept Obstet & Gynecol, Div Urogynecol, Linkou Med Ctr Chang Gung Univ, Sch Med Peoples Eibrat Soc Med Coll & Res Ctr, Dept Obstet & Gynaecol Cebu Velez Gen Hosp, Dept Obstet & Gynecol Chi Mei Fdn Hosp, Dept Obstet & Gynecol, Div Urogynecol & Pelv Floor Reconstruct Chia Nan Univ Pharm & Sci, Ctr Gen Educ
Keywords:	Efficacy Outcomes Risk factors Safety Solyx Stress incontinence
Date:	2019-05
Issue Date:	2020-07-29 13:50:19 (UTC+8)
Publisher:	ELSEVIER SCIENCE INC
Abstract:	Study Objective: To evaluate the clinical outcome and identify risk factors for failure of the Solyx (Boston Scientific Corporation, Marlborough, MA) single-incision sling (SIS) in the treatment of urodynamic stress incontinence (USI). Design: A retrospective observational study (Canadian Task Force classification II-2). Setting: A tertiary referral center. Patients: Patients diagnosed with USI without needing concurrent procedures that underwent continence surgery using the Solyx SIS from February 2015 to May 2017. Interventions: Anti-incontinence surgery. Measurements and Main Results: The primary outcome of this study was the rate of objective cure defined as the absence of demonstrable leakage of urine on the cough stress test and a 1-hour pad test weight of less than 2 g. The secondary outcome was the rate of subjective cure defined as a negative response to Urinary Distress Inventory question 3 (no leakage on coughing, sneezing, or laughing) and the identification of the different risk factors of cure failure. A total of 113 patients were evaluated in the study. Postoperative USI and the 1-hour pad test significantly improved from 24.2 +/- 26.9 gm (range, 19.1-29.3) to 2.5 +/- 8.7 gm (range, 0.9-4.2); p < 0.001 through 1 year. Data analysis showed an objective cure rate of 90% (102/113) and a subjective cure rate of 86% (97/113). USI recurred in 11 patients with no repeat surgery done because symptoms were tolerable to the patients. No patient had bladder outlet obstruction. Peak flow rates 23.7 +/- 9.1 ml/s (20.0-27.4) and residual urine volume 38.5 +/- 25.8 ml (29.8-47.2) were within normal limits with no significant changes. Previous anti-incontinent surgery, previous prolapsed surgery, intrinsic sphincter deficiency, maximum urethral closure pressure < 40 cm H2O, and neurogenic disease were significant risk factors for sling failure. Subjective assessment on the quality of life significantly improved (p < 0.001). Conclusion: The Solyx SIS is an effective and safe treatment option for women with USI, showing high objective and subjective cure rates with a low incidence of complications 1 year after treatment. The identified independent risk factors for failure are related to poor urethral function and previous pelvic reconstructive surgery. (C) 2018 AAGL. All rights reserved.
Relation:	Journal of Minimally Invasive Gynecology, v.26, n.4, pp.688-694
Appears in Collections:	[The Center For General Education] Periodical Articles

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