Complications and initial continence rates after a repeat pubovaginal sling procedure for recurrent stress urinary incontinence

Purpose: We evaluated the safety and efficacy of repeat pubovaginal sling p rocedures for recurrent stress urinary incontinence. Materials and Methods: We retrospectively reviewed the records of 14 patien ts in whom an initial suburethral sling procedure failed, who then underwen t a repeat pubovaginal sling procedure for recurrent stress urinary inconti nence at our institution and who were available for followup evaluation. Me an followup after re-operation was 17 months (range 5 to 41). The response to surgery was assessed using the Blaivas-Groutz anti-incontinence surgery response score. Results: There were no intraoperative complications. Mean blood loss was 15 5 cc (range 50 to 750) and average operative time was 101 minutes (range 80 to 145). Long-term urinary retention developed in 1 of the 14 patients (7% ). There were no deaths. Two patients (14%) had postoperative complications , including a pelvic abscess and osteomyelitis pubis in 1 each. Based on th e Blaivas-Groutz anti-incontinence scale 7 of the 14 patients (50%) were cu red, 1 (7%) had a good response, 4 (29%) had a fair response, 2 (14%) had a poor response and none had treatment failure. Subjectively 12 of the 14 wo men (86%) considered themselves cured or improved and 2 (14%) considered th e operation to have failed. Conclusions: Our data imply that a repeat pubovaginal sling procedure after an initial failed operation is associated with low complication and accept able continence rates. It should be considered a reasonable treatment optio n in select women with recurrent stress urinary incontinence.