Risk factors of recurrence of stress urinary incontinence after single-incision sling at 5 years

Abstract

Introduction and hypothesis: Stress urinary incontinence (SUI) affects 5-35% of women, especially at menopause. In severe cases or when conservative treatment fails, a tensión-free suburethral band is indicated. Similar short-medium term cure rates have been reported with mini-sling (SIS) compared to retropubic and transobturator band. But the long-term information is scarce and it seems that the risk of recurrence is not negligible (4-37%). There is little literatura that studies the posible predisposing factors for the recurrence of SUI after SIS. The objective is to identify factors associated with the risk of relapse of SUI at 5 years, after SIS. Methods: A prospective five-years follow-up observational study (2015-2019) was performed in women who underwent SUI using SIS. The sample was 115 patients with relapse of SUI. Statistics: T-Student or U-Mann and ROC for quantitative variables, Chi-Squared and OR for qualitative variables. Results: L25 patients (21.74%) had recurrence during the study period. Of all the variables analyzed, they only showed a significant association with the recurrence of SUI: height, weigth and BMI, a history of fetal macrosomia and the number of compresses used. The patients who presented recurrence of SUI had a lower heigth, greater weight, and therefore a higher BMI. The obstetrics history of a vaginal delivery with a fetus >4 kg, was associated with a higher risk of recurrence (OR: 4.05, IC 95%=1.09-15.03), and the use of a greater number of compresses was also associated with an increased risk of relapse, obtaining an area under the curve of 0.659. Conclusion: The 5-year recurrence rateo f SUI after mini-sling in our setting was 21.74%. A lower height, a greater weight and BMI, macrosomic delivery and greater number of purses have shown a significant association with the risk of relapse of SUI after mini-sling at 5 years. Therefore, it is essential to adecuately advise patients according to their personal factors of the potencial risk of recurrence after SIS.