Evaluation of clinical outcome and risk factors for failure of single-incision mid-urethral short tape procedure (Solyx™ tape) for stress urinary incontinence.

To evaluate the clinical outcome and identify risk factors for failure of Solyx™ single-incision sling (SIS) in the treatment of urodynamic stress incontinence (USI).

Retrospective observational study (Canadian Task Force classification II-2) SETTING: 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.

Anti-incontinence surgery MEASUREMENTS AND MAIN RESULTS: The primary outcome of this study is 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 two grams. The secondary outcome is 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 1-hour pad test significantly improved (p<.001) through one year. Analysis of data shows an objective cure of 90% (102/113) and subjective cure 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 and residual urine volume were within normal limits with no significant changes. Previous anti-incontinent surgery, previous prolapsed surgery, intrinsic sphincter deficiency (ISD), MUCP <40cmH2O and neurogenic disease were significant risk factors for sling failure. Subjective assessment on the quality of life significantly improved.

The Solyx SIS is an effective and safe treatment option for women with USI showing high objective and subjective cure rates with low incidence of complications at 1-year post-treatment. The identified independent risk factors for failure are related to poor urethral function and previous pelvic reconstructive surgery.

Journal of minimally invasive gynecology. 2018 Jul 21 [Epub ahead of print]

Tsia-Shu Lo, Nagashu Shailaja, Sandy Chua, Ling-Hong Tseng, Chuan-Chi Kao, Ming-Ping Wu

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung, Medical Center, Keelung, Taiwan, Republic of China; Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China; Chang Gung University, School of Medicine, Taoyuan, Taiwan, Republic of China. Electronic address: ., Department of Obstetrics and Gynaecology, Peoples Education Society Medical College and Research Centre, Kuppam, Andhra Pradesh, India., Fellow, Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China; Department of Obstetrics and Gynecology, Cebu Velez General Hospital, Cebu City, Philippines., Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China; Chang Gung University, School of Medicine, Taoyuan, Taiwan, Republic of China., Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung, Medical Center, Keelung, Taiwan, Republic of China; Chang Gung University, School of Medicine, Taoyuan, Taiwan, Republic of China., Division of Urogynecology and Pelvic Floor Reconstruction, Department of Obstetrics and Gynecology, Chi Mei Foundation Hospital, Tainan, Taiwan, Republic of China; Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan, Republic of China.

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