Management of recurrent stress XXXX after burch and sling procedures.

@entity1 @entity322 @entity4438
AIMS: To examine treatment options selected for recurrent stress @entity322 (rSUI) in follow-up after Burch, autologous fascial and synthetic midurethral sling (MUS) procedures. METHODS: We performed a secondary analysis of the SISTER and ToMUS trials of @entity1 who underwent primary stress @entity322 (SUI) treatment (without prior SUI surgery or concomitant procedures). Using Kaplan-Meier analysis, retreatment-free survival rates by initial surgical procedure were compared. Mean MESA (Medical Epidemiologic and Social Aspects of Aging) stress index was also compared between those retreated for rSUI compared to those not retreated. RESULTS: Half of the @entity1 in the SISTEr trial met inclusion criteria for this analysis (329/655, 174 Burch and 155 @entity4438 ), as did 444/597 (74%) of subjects in ToMUS (221 transobturator midurethral sling (TMUS), and 223 retropubic midurethral sling (RMUS). Types of surgical retreatment included @entity4438 (19), synthetic sling (1), and bulking agent (18). Five-year retreatment free survival rates (and standard errors) were 87% (3%), 96% (2%), 97% (1%), and 99% (0.7%) for Burch, @entity4438 , TMUS, and RMUS groups respectively (P   <   0.0001). For all index surgery groups, the mean MESA stress index at last visit prior to retreatment for those retreated (n   =   23) was significantly higher than mean MESA stress index at last visit for those not retreated (n   =   645) (P   <   0.0001). CONCLUSION: In these cohorts, 6% of @entity1 after standard anti- @entity322 procedures were retreated within 5 years, mostly with injection therapy or @entity4438 . Not all @entity1 with rSUI chose surgical retreatment.
