Does the suburethral sling change its location?
OBJECTIVES
To ascertain whether a phenomenon of sling migration exists after suburethral sling placement, whether this might be responsible for suboptimal sling location and persistent incontinence, and whether a link exists between sling dislocation or migration and risk factors, such as obesity or age.


METHODS
The present prospective cohort study was carried out in a group of 244 patients who underwent retropubic sling implantation. Sling location was determined by means of pelvic floor ultrasound, and calculated relative to the individual patient's urethral length measured before the procedure. The sling location was visualized on 1 day, and 1 and 6 months post-surgery. Overweight/obese and elderly patients were analyzed separately to assess the possible influence of those factors on sling location.


RESULTS
The mean urethral length in the studied cohort was 28.76 ± 3.67 mm. The mean tape position 1 day post-surgery was 66.18 ± 8.43% of the urethral length, and it did not change 1 and 6 months post-surgery in the whole group. Similar results were obtained in elderly and overweight/obese patients.


CONCLUSIONS
Suboptimal sling location appears to result from incorrect surgical technique, and should be diagnosed and treated early after the primary surgery. Sling location does not change after mid-term follow up.
['Majkusiak|Wojciech|W|', 'Pomian|Andrzej|A|', 'Tomasik|Paweł|P|', 'Horosz|Edyta|E|', 'Zwierzchowska|Aneta|A|', 'Kociszewski|Jacek|J|', 'Barcz|Ewa|E|']
D000368:Aged D005260:Female D006801:Humans D009765:Obesity D017773:Pelvic Floor D011044:Poland D011183:Postoperative Complications D011446:Prospective Studies D011475:Prosthesis Failure D012307:Risk Factors D053825:Suburethral Slings D014463:Ultrasonography D014521:Urethra D001743:Urinary Bladder D014550:Urinary Incontinence, Stress D013520:Urologic Surgical Procedures
suburethral slings ultrasound complications operative surgical procedures stress urinary incontinence