11 years on: The effects of repeat vaginal sling procedures

This study examined the effects of a repeat (second) vaginal sling procedure to treat recurrent stress urinary incontinence (SUI) over 11 years. Authors concluded that repeat vaginal sling procedure is a suitable long-term treatment option for recurrent SUI after failure of a first one.

Vaginal sling procedures are currently the most common type of surgery used to help control SUI. They involve a minimally invasive procedure placing a mesh tape to create a ‘sling’ of support around the urethra. Previous studies have found them to be an effective long-term treatment option for SUI. However, in some cases vaginal sling procedures fail. A second (repeat) sling surgery can be offered. The long-term effects of repeat sling procedures are still being investigated.

The aim of this study was to examine the long-term effects of a repeat vaginal sling procedure.

33 women treated for recurrent SUI with a second vaginal sling procedure were included. Physical examinations and self-reported questionnaires recorded safety and effectiveness of the repeat procedure. The average time at follow-up since the repeat procedure was 11 years.

At follow-up, 67% of women reported to be free of SUI symptoms since the repeat vaginal sling procedure. Another questionnaire rated the success rate of the repeat procedure to be 78%. 65% of women were considered continent at follow-up based on physical examinations (on no urinary leakage during a cough stress test).

None of the women experienced tape erosion or showed tape material in the bladder, urethra or vagina. 70% of women reported overactive bladder symptoms (such as urinary urgency). Two women underwent a third vaginal sling procedure and were continent at follow-up. No significant differences in quality of life or sexual health were reported at follow-up compared to before repeat surgery. 

Authors concluded that repeat vaginal sling procedure are a suitable long-term treatment option for recurrent SUI after failure of a first one.

Larger studies are needed to confirm the long-term effectiveness of repeat vaginal sling procedures.