TY - JOUR
T1 - Outcomes of Macroplastique injections for stress urinary incontinence after suburethral sling removal
AU - Rodríguez, Dayron
AU - Carroll, Timothy
AU - Alhalabi, Feras
AU - Carmel, Maude
AU - Zimmern, Philippe E.
N1 - Publisher Copyright:
© 2020 Wiley Periodicals, Inc.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Introduction: To evaluate outcomes following urethral Macroplastique (MPQ) injection in women with stress urinary incontinence (SUI) following suburethral sling removal (SSR) for synthetic sling complications. Methods: Following Institutional Review Board approval, charts of non-neurogenic women with SUI after SSR who underwent MPQ injection(s) and had at least 6 months minimum follow-up were reviewed from a prospectively maintained database. Demographic data, questionnaire (Urogenital Distress Inventory-6 [UDI-6] and Quality of Life) scores, and pad usage were recorded. Patients were followed with repeat questionnaires and three-dimensional ultrasound evaluating MPQ volume. Success following MPQ was defined as a composite score of a UDI-6 question 3 score of 0 to 1 at last visit and no additional anti-incontinence therapy. Results: From 2011 to 2018, 70 women with mean age 62.7 years met study criteria. At a mean follow-up of 46.4 ± 1.5 months, the success rate after the first MPQ injection was 46%. Following a repeat MPQ injection when indicated, the overall success rate for the entire cohort was 69%. Despite the objective failure, the majority of patients reported subjective improvement (83%) and reduced pad usage (78%). On multivariate analysis: age, body mass index, previous hysterectomy, hormone replacement therapy, type of sling removed and baseline urodynamics (UDS) parameters were not predictors of MPQ failure. Higher parity was a predictor of MPQ failure (hazard ratio = 1.980; P =.032). Conclusion: MPQ injection is a durable and effective management option for SUI following SSR, although a second injection may be required to achieve the desired success.
AB - Introduction: To evaluate outcomes following urethral Macroplastique (MPQ) injection in women with stress urinary incontinence (SUI) following suburethral sling removal (SSR) for synthetic sling complications. Methods: Following Institutional Review Board approval, charts of non-neurogenic women with SUI after SSR who underwent MPQ injection(s) and had at least 6 months minimum follow-up were reviewed from a prospectively maintained database. Demographic data, questionnaire (Urogenital Distress Inventory-6 [UDI-6] and Quality of Life) scores, and pad usage were recorded. Patients were followed with repeat questionnaires and three-dimensional ultrasound evaluating MPQ volume. Success following MPQ was defined as a composite score of a UDI-6 question 3 score of 0 to 1 at last visit and no additional anti-incontinence therapy. Results: From 2011 to 2018, 70 women with mean age 62.7 years met study criteria. At a mean follow-up of 46.4 ± 1.5 months, the success rate after the first MPQ injection was 46%. Following a repeat MPQ injection when indicated, the overall success rate for the entire cohort was 69%. Despite the objective failure, the majority of patients reported subjective improvement (83%) and reduced pad usage (78%). On multivariate analysis: age, body mass index, previous hysterectomy, hormone replacement therapy, type of sling removed and baseline urodynamics (UDS) parameters were not predictors of MPQ failure. Higher parity was a predictor of MPQ failure (hazard ratio = 1.980; P =.032). Conclusion: MPQ injection is a durable and effective management option for SUI following SSR, although a second injection may be required to achieve the desired success.
KW - Macroplastique
KW - bulking agent
KW - intrinsic sphincter deficiency
KW - sling removal
KW - stress urinary incontinence
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U2 - 10.1002/nau.24321
DO - 10.1002/nau.24321
M3 - Article
C2 - 32068306
AN - SCOPUS:85079728652
SN - 0733-2467
VL - 39
SP - 994
EP - 1001
JO - Neurourology and urodynamics
JF - Neurourology and urodynamics
IS - 3
ER -