A second vaginal sling procedure is effective in treating persistent stress urinary incontinence

This study examined the effectiveness of a repeat (second) vaginal sling procedure to treat persistent stress urinary incontinence (SUI). Researchers concluded that a repeat vaginal sling procedure is an effective treatment option following failure of a first sling procedure.

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 (urinary tract). Previous studies have found them to be an effective long-term treatment option for SUI. However, it has been estimated that 5 to 20% of women continue to experience incontinence after a vaginal sling procedure. Repeated sling surgery can be offered in these cases. The effectiveness of a repeat sling procedure in treating persistent SUI is still being investigated.

The aim of this study was to report outcomes of repeat vaginal sling procedures following failure of a first sling surgery.

The records of 224 women undergoing a repeat vaginal sling procedure for SUI were included in analysis. All women had persistent SUI following the first sling surgery. 8.5% of women had failed more than one prior sling surgery. Treatment outcomes were followed for an average of 29 months.

61.4% of women reported no urinary leakage during physical activity, coughing, or sneezing at follow-up. 66.1% of women were considered continent based on incontinence pad use. The average number of pads used per day reduced from 3.3 before repeat sling surgery to 0.8 after surgery. No significant differences were observed between the type of vaginal sling procedure undertaken.

17.4% of women had complications after surgery. Urinary retention (a temporary inability to pass urine requiring intervention) was the most common complication (5.8%). 5.4% of women developed urinary urgency after the procedure (a sudden and compelling need to pass urine). 1.8% of women developed a minor wound infection.

Researchers concluded that a repeat vaginal sling procedure is safe and effective in treating persistent SUI.