UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2016 UpToDate®

Stress urinary incontinence in women: Persistent/recurrent symptoms after surgical treatment

Author
Daniel M Morgan, MD
Section Editor
Linda Brubaker, MD, FACS, FACOG
Deputy Editor
Kristen Eckler, MD, FACOG

INTRODUCTION

Stress urinary incontinence (SUI), the involuntary leakage of urine on effort or exertion or on sneezing or coughing, affects 4 to 35 percent of women [1-3]. In 2006, 1 in 1000 women in the United States had surgical treatment of incontinence [4]. The majority of women are adequately treated with one procedure, but up to 15 percent of women require further treatment for persistent/recurrent SUI [5].

The evaluation and management of recurrent or persistent SUI after a primary surgical treatment are reviewed here. Choosing a primary treatment procedure and preoperative evaluation of women prior to a primary procedure are discussed in detail separately. (See "Surgical management of stress urinary incontinence in women: Choosing a primary surgical procedure" and "Surgical management of stress urinary incontinence in women: Preoperative evaluation for a primary procedure".)

TERMINOLOGY

Persistent stress urinary incontinence (SUI) refers to SUI symptoms that persist despite performance of a surgical procedure intended to resolve these SUI symptoms.

Recurrent SUI refers to recurrence of SUI symptoms after a period without SUI symptoms following surgery.

Additional terminology for SUI treatment procedures can be found separately. (See "Surgical management of stress urinary incontinence in women: Choosing a primary surgical procedure", section on 'Terminology'.)

                           

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Nov 2016. | This topic last updated: Thu Oct 13 00:00:00 GMT 2016.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
References
Top
  1. Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 2010; 29:4.
  2. Luber KM. The definition, prevalence, and risk factors for stress urinary incontinence. Rev Urol 2004; 6 Suppl 3:S3.
  3. Kane AR, Nager CW. Midurethral slings for stress urinary incontinence. Clin Obstet Gynecol 2008; 51:124.
  4. Oliphant SS, Jones KA, Wang L, et al. Trends over time with commonly performed obstetric and gynecologic inpatient procedures. Obstet Gynecol 2010; 116:926.
  5. Jonsson Funk M, Siddiqui NY, Kawasaki A, Wu JM. Long-term outcomes after stress urinary incontinence surgery. Obstet Gynecol 2012; 120:83.
  6. Fialkow M, Symons RG, Flum D. Reoperation for urinary incontinence. Am J Obstet Gynecol 2008; 199:546.e1.
  7. Zimmern PE, Gormley EA, Stoddard AM, et al. Management of recurrent stress urinary incontinence after burch and sling procedures. Neurourol Urodyn 2016; 35:344.
  8. Hellberg D, Holmgren C, Lanner L, Nilsson S. The very obese woman and the very old woman: tension-free vaginal tape for the treatment of stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2007; 18:423.
  9. Richter HE, Goode PS, Brubaker L, et al. Two-year outcomes after surgery for stress urinary incontinence in older compared with younger women. Obstet Gynecol 2008; 112:621.
  10. Barber MD, Kleeman S, Karram MM, et al. Risk factors associated with failure 1 year after retropubic or transobturator midurethral slings. Am J Obstet Gynecol 2008; 199:666.e1.
  11. Richter HE, Litman HJ, Lukacz ES, et al. Demographic and clinical predictors of treatment failure one year after midurethral sling surgery. Obstet Gynecol 2011; 117:913.
  12. Chen HY, Yeh LS, Chang WC, Ho M. Analysis of risk factors associated with surgical failure of inside-out transobturator vaginal tape for treating urodynamic stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2007; 18:443.
  13. Cetinel B, Demirkesen O, Onal B, et al. Are there any factors predicting the cure and complication rates of tension-free vaginal tape? Int Urogynecol J Pelvic Floor Dysfunct 2004; 15:188.
  14. Ankardal M, Heiwall B, Lausten-Thomsen N, et al. Short- and long-term results of the tension-free vaginal tape procedure in the treatment of female urinary incontinence. Acta Obstet Gynecol Scand 2006; 85:986.
  15. Holmgren C, Nilsson S, Lanner L, Hellberg D. Long-term results with tension-free vaginal tape on mixed and stress urinary incontinence. Obstet Gynecol 2005; 106:38.
  16. Richter HE, Diokno A, Kenton K, et al. Predictors of treatment failure 24 months after surgery for stress urinary incontinence. J Urol 2008; 179:1024.
  17. Richter HE, Brubaker L, Stoddard AM, et al. Patient related factors associated with long-term urinary continence after Burch colposuspension and pubovaginal fascial sling surgeries. J Urol 2012; 188:485.
  18. Daneshgari F, Moore C, Frinjari H, Babineau D. Patient related risk factors for recurrent stress urinary incontinence surgery in women treated at a tertiary care center. J Urol 2006; 176:1493.
  19. Richter HE, Albo ME, Zyczynski HM, et al. Retropubic versus transobturator midurethral slings for stress incontinence. N Engl J Med 2010; 362:2066.
  20. Paick JS, Ku JH, Shin JW, et al. Tension-free vaginal tape procedure for urinary incontinence with low Valsalva leak point pressure. J Urol 2004; 172:1370.
  21. Stav K, Dwyer PL, Rosamilia A, et al. Risk factors of treatment failure of midurethral sling procedures for women with urinary stress incontinence. Int Urogynecol J 2010; 21:149.
  22. Nager CW, Sirls L, Litman HJ, et al. Baseline urodynamic predictors of treatment failure 1 year after mid urethral sling surgery. J Urol 2011; 186:597.
  23. Nager CW, FitzGerald M, Kraus SR, et al. Urodynamic measures do not predict stress continence outcomes after surgery for stress urinary incontinence in selected women. J Urol 2008; 179:1470.
  24. Sanses TV, Brubaker L, Xu Y, et al. Preoperative hesitating urinary stream is associated with postoperative voiding dysfunction and surgical failure following Burch colposuspension or pubovaginal rectus fascial sling surgery. Int Urogynecol J 2011; 22:713.
  25. Rafii A, Daraï E, Haab F, et al. Body mass index and outcome of tension-free vaginal tape. Eur Urol 2003; 43:288.
  26. Miranda V, Pineda R, Lovatsis D, et al. Efficacy and safety of tension-free vaginal tape compared with transobturator tape among obese women with stress urinary incontinence: a retrospective cohort study. J Obstet Gynaecol Can 2012; 34:755.
  27. Esin S, Salman MC, Ozyuncu O, Durukan T. Surgical outcome of transobturator tape procedure in obese and non-obese women. J Obstet Gynaecol 2011; 31:645.
  28. Mohamad Al-Ali B, Hutterer GC, Puchwein E, et al. Clinical impact of body mass index on the outcome of the SPARC-sling system for the treatment of female stress urinary incontinence. World J Urol 2013; 31:875.
  29. Nilsson CG, Kuuva N, Falconer C, et al. Long-term results of the tension-free vaginal tape (TVT) procedure for surgical treatment of female stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2001; 12 Suppl 2:S5.
  30. Kenton K, Mahajan S, Fitzgerald MP, Brubaker L. Recurrent stress incontinence is associated with decreased neuromuscular function in the striated urethral sphincter. Am J Obstet Gynecol 2006; 194:1434.
  31. Chapple CR, Wein AJ, Brubaker L, et al. Stress incontinence injection therapy: what is best for our patients? Eur Urol 2005; 48:552.
  32. Nygaard I. Physiologic outcome measures for urinary incontinence. Gastroenterology 2004; 126:S99.
  33. Bakas P, Liapis A, Creatsas G. Q-tip test and tension-free vaginal tape in the management of female patients with genuine stress incontinence. Gynecol Obstet Invest 2002; 53:170.
  34. Liapis A, Bakas P, Lazaris D, Creatsas G. Tension-free vaginal tape in the management of recurrent stress incontinence. Arch Gynecol Obstet 2004; 269:205.
  35. Ordorica R, Rodriguez AR, Coste-Delvecchio F, et al. Disabling complications with slings for managing female stress urinary incontinence. BJU Int 2008; 102:333.
  36. Foley C, Patki P, Boustead G. Unrecognized bladder perforation with mid-urethral slings. BJU Int 2010; 106:1514.
  37. Fritel X, Zabak K, Pigne A, et al. Predictive value of urethral mobility before suburethral tape procedure for urinary stress incontinence in women. J Urol 2002; 168:2472.
  38. Winters JC, Dmochowski RR, Goldman HB, et al. Urodynamic studies in adults: AUA/SUFU guideline. J Urol 2012; 188:2464.
  39. Kociszewski J, Rautenberg O, Perucchini D, et al. Tape functionality: sonographic tape characteristics and outcome after TVT incontinence surgery. Neurourol Urodyn 2008; 27:485.
  40. Kociszewski J, Rautenberg O, Kuszka A, et al. Can we place tension-free vaginal tape where it should be? The one-third rule. Ultrasound Obstet Gynecol 2012; 39:210.
  41. Jiang YH, Wang CC, Chuang FC, et al. Positioning of a suburethral sling at the bladder neck is associated with a higher recurrence rate of stress urinary incontinence. J Ultrasound Med 2013; 32:239.
  42. Yang JM, Yang SH, Huang WC, Tzeng CR. Correlation of tape location and tension with surgical outcome after transobturator suburethral tape procedures. Ultrasound Obstet Gynecol 2012; 39:458.
  43. Minaglia S, Urwitz-Lane R, Wong M, Ozel B. Effectiveness of transobturator tape in women with decreased urethral mobility. J Reprod Med 2009; 54:15.
  44. Kirchin V, Page T, Keegan PE, et al. Urethral injection therapy for urinary incontinence in women. Cochrane Database Syst Rev 2012; :CD003881.
  45. Gaddi A, Guaderrama N, Bassiouni N, et al. Repeat midurethral sling compared with urethral bulking for recurrent stress urinary incontinence. Obstet Gynecol 2014; 123:1207.
  46. Kasi AD, Pergialiotis V, Perrea DN, et al. Polyacrylamide hydrogel (Bulkamid®) for stress urinary incontinence in women: a systematic review of the literature. Int Urogynecol J 2016; 27:367.
  47. Sweat SD, Lightner DJ. Complications of sterile abscess formation and pulmonary embolism following periurethral bulking agents. J Urol 1999; 161:93.
  48. Isom-Batz G, Zimmern PE. Collagen injection for female urinary incontinence after urethral or periurethral surgery. J Urol 2009; 181:701.
  49. Keegan PE, Atiemo K, Cody J, et al. Periurethral injection therapy for urinary incontinence in women. Cochrane Database Syst Rev 2007; :CD003881.
  50. Kiilholma PJ, Chancellor MB, Makinen J, et al. Complications of Teflon injection for stress urinary incontinence. Neurourol Urodyn 1993; 12:131.
  51. Hurtado E, McCrery R, Appell R. The safety and efficacy of ethylene vinyl alcohol copolymer as an intra-urethral bulking agent in women with intrinsic urethral deficiency. Int Urogynecol J Pelvic Floor Dysfunct 2007; 18:869.
  52. Sahai A, Thomas M, Nedas T, et al. Periurethral non-animal stabilized hyaluronic acid/dextranomer injections: efficacy and formation of granuloma/sterile abscess. Urology 2009; 74:486.
  53. Madjar S, Sharma AK, Waltzer WC, et al. Periurethral mass formations following bulking agent injection for the treatment of urinary incontinence. J Urol 2006; 175:1408.
  54. Mayer RD, Dmochowski RR, Appell RA, et al. Multicenter prospective randomized 52-week trial of calcium hydroxylapatite versus bovine dermal collagen for treatment of stress urinary incontinence. Urology 2007; 69:876.
  55. Lai HH, Hurtado EA, Appell RA. Large urethral prolapse formation after calcium hydroxylapatite (Coaptite) injection. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19:1315.
  56. Ko EY, Williams BF, Petrou SP. Bulking agent induced early urethral prolapse after distal urethrectomy. Int Urogynecol J Pelvic Floor Dysfunct 2007; 18:1511.
  57. Berger MB, Morgan DM. Delayed presentation of pseudoabscess secondary to injection of pyrolytic carbon-coated beads bulking agent. Female Pelvic Med Reconstr Surg 2012; 18:303.
  58. Lightner D, Calvosa C, Andersen R, et al. A new injectable bulking agent for treatment of stress urinary incontinence: results of a multicenter, randomized, controlled, double-blind study of Durasphere. Urology 2001; 58:12.
  59. Chrouser KL, Fick F, Goel A, et al. Carbon coated zirconium beads in beta-glucan gel and bovine glutaraldehyde cross-linked collagen injections for intrinsic sphincter deficiency: continence and satisfaction after extended followup. J Urol 2004; 171:1152.
  60. Ghoniem GM, Miller CJ. A systematic review and meta-analysis of Macroplastique for treating female stress urinary incontinence. Int Urogynecol J 2013; 24:27.
  61. Schulz JA, Nager CW, Stanton SL, Baessler K. Bulking agents for stress urinary incontinence: short-term results and complications in a randomized comparison of periurethral and transurethral injections. Int Urogynecol J Pelvic Floor Dysfunct 2004; 15:261.
  62. Kuhn A, Stadlmayr W, Lengsfeld D, Mueller MD. Where should bulking agents for female urodynamic stress incontinence be injected? Int Urogynecol J Pelvic Floor Dysfunct 2008; 19:817.
  63. Hansen MF, Lose G, Kesmodel US, Gradel KO. Repeat surgery after failed midurethral slings: a nationwide cohort study, 1998-2007. Int Urogynecol J 2016; 27:1013.
  64. Nikolopoulos KI, Betschart C, Doumouchtsis SK. The surgical management of recurrent stress urinary incontinence: a systematic review. Acta Obstet Gynecol Scand 2015; 94:568.
  65. Lee RA, Symmonds RE. Repeat Marshall-Marchetti procedure for recurrent stress urinary incontinence. Am J Obstet Gynecol 1975; 122:219.
  66. Amaye-Obu FA, Drutz HP. Surgical management of recurrent stress urinary incontinence: A 12-year experience. Am J Obstet Gynecol 1999; 181:1296.
  67. Huang YH, Lin AT, Chen KK, et al. High failure rate using allograft fascia lata in pubovaginal sling surgery for female stress urinary incontinence. Urology 2001; 58:943.
  68. Carbone JM, Kavaler E, Hu JC, Raz S. Pubovaginal sling using cadaveric fascia and bone anchors: disappointing early results. J Urol 2001; 165:1605.
  69. Soergel TM, Shott S, Heit M. Poor surgical outcomes after fascia lata allograft slings. Int Urogynecol J Pelvic Floor Dysfunct 2001; 12:247.
  70. Simsiman AJ, Powell CR, Stratford RR, Menefee SA. Suburethral sling materials: best outcome with autologous tissue. Am J Obstet Gynecol 2005; 193:2112.
  71. McBride AW, Ellerkmann RM, Bent AE, Melick CF. Comparison of long-term outcomes of autologous fascia lata slings with Suspend Tutoplast fascia lata allograft slings for stress incontinence. Am J Obstet Gynecol 2005; 192:1677.
  72. Dmochowski RR, Blaivas JM, Gormley EA, et al. Update of AUA guideline on the surgical management of female stress urinary incontinence. J Urol 2010; 183:1906.
  73. Giri SK, Hickey JP, Sil D, et al. The long-term results of pubovaginal sling surgery using acellular cross-linked porcine dermis in the treatment of urodynamic stress incontinence. J Urol 2006; 175:1788.
  74. Morgan DM, Dunn RL, Fenner DE, et al. Comparative analysis of urinary incontinence severity after autologous fascia pubovaginal sling, pubovaginal sling and tension-free vaginal tape. J Urol 2007; 177:604.
  75. Abdel-Fattah M, Barrington JW, Arunkalaivanan AS. Pelvicol pubovaginal sling versus tension-free vaginal tape for treatment of urodynamic stress incontinence: a prospective randomized three-year follow-up study. Eur Urol 2004; 46:629.
  76. Guerrero KL, Emery SJ, Wareham K, et al. A randomised controlled trial comparing TVT, Pelvicol and autologous fascial slings for the treatment of stress urinary incontinence in women. BJOG 2010; 117:1493.
  77. Milose JC, Sharp KM, He C, et al. Success of autologous pubovaginal sling after failed synthetic mid urethral sling. J Urol 2015; 193:916.
  78. McGuire EJ, Lytton B. Pubovaginal sling procedure for stress incontinence. 1978. J Urol 2002; 167:1120.
  79. Albo ME, Richter HE, Brubaker L, et al. Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med 2007; 356:2143.
  80. Pradhan A, Jain P, Latthe PM. Effectiveness of midurethral slings in recurrent stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J 2012; 23:831.
  81. Parden AM, Gleason JL, Jauk V, et al. Incontinence outcomes in women undergoing primary and repeat midurethral sling procedures. Obstet Gynecol 2013; 121:273.
  82. Stav K, Dwyer PL, Rosamilia A, et al. Repeat synthetic mid urethral sling procedure for women with recurrent stress urinary incontinence. J Urol 2010; 183:241.
  83. Smith AL, Karp DR, Aguilar VC, Davila GW. Repeat versus primary slings in patients with intrinsic sphincter deficiency. Int Urogynecol J 2013; 24:963.
  84. Lo TS, Wang AC, Liang CC, et al. Treatment for unsuccessful tension-free vaginal tape operation by shortening pre-implanted tape. J Urol 2006; 175:2196.
  85. Schmid C, Bloch E, Amann E, et al. An adjustable sling in the management of recurrent urodynamic stress incontinence after previous failed midurethral tape. Neurourol Urodyn 2010; 29:573.
  86. Park BH, Kim JC, Kim HW, et al. Midterm efficacy and complications of readjustable midurethral sling (Remeex system) in female stress urinary incontinence with recurrence or intrinsic sphincter deficiency. Urology 2015; 85:79.
  87. Rutman MP, Deng DY, Shah SM, et al. Spiral sling salvage anti-incontinence surgery in female patients with a nonfunctional urethra: technique and initial results. J Urol 2006; 175:1794.
  88. Ghoniem GM, Khater UM. Urodynamics. In: Pelvic Floor Dysfunction, Willy Davila G, Ghoniem GM, Wexner SD (Eds), Springer-Verlag, London 2006. p.35.
  89. Rodriguez AR, Hakky T, Hoffman M, et al. Salvage spiral sling techniques: alternatives to manage disabling recurrent urinary incontinence in females. J Urol 2010; 184:2429.
  90. Cornu JN, Sèbe P, Peyrat L, et al. Midterm prospective evaluation of TVT-Secur reveals high failure rate. Eur Urol 2010; 58:157.
  91. Basu M, Duckett J. A randomised trial of a retropubic tension-free vaginal tape versus a mini-sling for stress incontinence. BJOG 2010; 117:730.
  92. Dainer M, Hall CD, Choe J, Bhatia NN. The Burch procedure: a comprehensive review. Obstet Gynecol Surv 1999; 54:49.
  93. Hussain M, Greenwell TJ, Venn SN, Mundy AR. The current role of the artificial urinary sphincter for the treatment of urinary incontinence. J Urol 2005; 174:418.
  94. Venn SN, Greenwell TJ, Mundy AR. The long-term outcome of artificial urinary sphincters. J Urol 2000; 164:702.
  95. Fichtner J. Follow-up after urinary diversion. Urol Int 1999; 63:40.