Document Detail

Midurethral sling procedures for stress urinary incontinence in women over 80 years.
MedLine Citation:
PMID:  20878996     Owner:  NLM     Status:  MEDLINE    
AIMS: To compare the safety and efficacy of midurethral sling surgery for management of urinary stress incontinence in women over 80 years versus younger women.
METHODS: 1225 consecutive women with urodynamic stress incontinence had a synthetic midurethral sling (955 retropubic, 270 transobturator) at our institution between 1999 and 2007. Ninety one percent (n = 1112) of the patients were interviewed via phone call with a structured questionnaire and were included in the analysis. The mean follow-up was 50 ± 24 months (range 12-114). Comparison between elderly (≥80 years, n = 96) and younger patients (<80 years, n = 1016) was performed.
RESULTS: The overall subjective cure rate was 85% (elderly 81%, younger 85%,  = 0.32). There was no significant difference in cure rate between retropubic and transobturator sling in the elderly group (82% vs. 79.3%, P = 0.75). The bladder perforation rate was similar between the two groups (3%). The hospitalization time was significantly longer in the elderly (1.6 ± 1.7 days vs. 0.7 ± 1.1 days, P<0.001). However, major perioperative complications were uncommon (1%). Of the patients who had an isolated sling procedure, 37% of the elderly and 9% of the young patients failed their 1st trial of void (P < 0.001). However, the long-term rate of voiding difficulty was similar between the two groups (elderly 8% vs. young 6%, P = 0.21). The rate of de novo urge incontinence was similar between the two groups (7%).
CONCLUSION: Retropubic and transobturator slings in women older than 80 years are effective and safe but are associated with an increased risk of transient postoperative voiding difficulty.
Kobi Stav; Peter L Dwyer; Anna Rosamilia; Lore Schierlitz; Yik N Lim; Joseph Lee
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Neurourology and urodynamics     Volume:  29     ISSN:  1520-6777     ISO Abbreviation:  Neurourol. Urodyn.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-29     Completed Date:  2011-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8303326     Medline TA:  Neurourol Urodyn     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1262-6     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley-Liss, Inc.
Department of Urogynaecology (affiliated to Melbourne University), Mercy Hospital for Women, Melbourne, Victoria, Australia.
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MeSH Terms
Age Factors
Aged, 80 and over
Chi-Square Distribution
Length of Stay
Logistic Models
Middle Aged
Risk Assessment
Risk Factors
Suburethral Slings* / adverse effects
Time Factors
Treatment Outcome
Urinary Incontinence, Stress / physiopathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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