Following midurethral versus bladder sling procedures

Objective The objective of the study was to compare detrusor overactivity and urge urinary incontinence rates after midurethral slings versus bladder neck slings. Study design Three hundred forty subjects underwent midurethral slings or bladder neck slings. Comparisons were made using Studentʹs t test and χ2 test. Multivariate analysis was performed to detect confounding factors. Results More patients in the midurethral sling group resolved detrusor overactivity than in the bladder neck sling group (38% versus 15%, P< .001). In addition, subjects in the midurethral sling group had significantly lower rates of de novo detrusor overactivity than subjects in the bladder neck sling group (29% versus 62%, P = .002). The only significant predictors of postoperative detrusor overactivity were preoperative detrusor overactivity (P< .001) and sling type (P< .001). After adjusting for preoperative detrusor overactivity, bladder neck slings significantly increased the risk for persistent detrusor overactivity (odds ratio 3.9). Conclusion Midurethral slings have increased rates of resolution of detrusor overactivity and lower rates of de novo detrusor overactivity than transvaginal bladder neck sling procedures.