After IRB approval, symptomatic women from outside referrals requiring SSR at least 10 years following MUS placement and with a minimum follow-up of 6 months post-SSR were enrolled. Exclusion criteria included neurogenic patients, additional procedures at times of SSR, and those not reachable for phone update. Demographics, past medical history, original MUS operative note, presenting symptoms, pre-SSR evaluation, peri-operative complications, post-SSR symptoms at last visit, were collected from EMR (EPIC). For those not seen in the past 2 years, a standardized phone interview using validated questionnaires was performed by a neutral investigator not involved in the care of these patients.
From 2006 to 2023, 58 patients met study criteria with mean age of 65 ± 10.5 years and predominantly Caucasian (91%). Nine were reached by phone and 4 were lost to follow-up. Time from initial MUS procedure to SSR removal was 16.7 ± 3.9 years. Most MUS were TVT (76%), followed by TOT (18%). At presentation, 90% of patients reported pain, 86% dyspareunia, 69% recurrent UTI, 52% SUI, and 53% urge urinary incontinence. Multiple presenting symptoms were observed in 83% of patients. At a mean follow-up of 2,2 years, SSR resulted in resolution of pain in 50% of patients, dyspareunia in 50%, recurrent UTI in 60%, SUI in 29%, and urge urinary incontinence in 37%, for each respective initial symptom. Some patients reported de novo pain (3%), UTIs (2%), SUI (9%) or urge urinary incontinence (7%). 7% required subsequent surgery for UI or persistent pain-related issues.
Patients can present 10+ years after MUS placement with complications, so it is important that pelvic reconstructive surgeons monitor these patients over time. Additionally, these long-term risks should be shared with patients considering a MUS.
