Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Höllein, A.
SLING DIVISION
Evaluation of the objective outcome and quality of life
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2017. pp.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Gold ehem Ulrich Daniela
- Altmetrics:
- Abstract:
- Background: Midurethral sling procedures may cause long-term complications such as voiding dysfunction, groin pain and de novo urgency, which can lead to the indication of sling division. There is little literature available about stress urinary incontinence (SUI) rates and the quality of life (QoL) after sling division. The aim of this study was to analyse the postoperative objective and subjective outcome of a sling division and its impact on the QoL of these patients. Additionally, possible risk factors that could lead to a sling division were analysed. Methods: Patients who underwent a sling division of a suburethral sling between 1999 until 2015 were invited for follow-up. For each case, two matching control patients were invited. A medical history was taken and urogynaecological as well as urodynamic examinations were performed. Objective SUI was defined as a positive stress test at bladder filling of 300 ml. Subjective SUI was defined when patients responded “yes” to the question: “Does urine leak when you are physically active, exert yourself, cough, or sneeze?”. Subjective success was assessed with the Patient’s Global Impression of Improvement (PGI-I) and the scores on a visual analogue scale (VAS) regarding the impact of incontinence. Patients completed the KING’s Health Questionnaire (KHQ), the Incontinence Outcome Questionnaire (IOQ) and the Female Sexual Function Index (FSFI). Results: 15 patients were available for follow-up and completed the questionnaires. 13 women attended the clinical follow-up examination. The objective SUI rate was 33.3% in the sling division group and 11.1% in the control group. In comparison the subjective SUI rate was 53.3% in the sling division group and 16.6% in the control group. The sling division group has low subjective success, low QoL and a poor sexual health after the sling division. The type of sling procedure (p = 0.038), a concomitant surgery (p = 0.048) and a previous gynaecological surgery (p = 0.031) were identified as potential risk factors for sling division. Conclusion: Poor subjective and objective outcome, low QoL and poor sexual health in women after sling division are shown in comparison to a control group.