Functional Outcomes After Revision of Mid-Urethral Sling

Purpose of ReviewStress urinary incontinence is a common condition and approximately 14% will undergo surgical intervention for treatment. Midurethral sling (MUS) is commonly indicated for the treatment of SUI, but up to 8% of women will under sling revision within 15 years of placement for complications. In this review, the current literature on functional outcomes after mid-urethral sling removal will be reviewed. Topics of focus include pain, dyspareunia, stress urinary incontinence, urgency urinary incontinence, and mixed incontinence.Recent FindingsSling revision may be indicated for women who developed voiding dysfunction, pain, or mesh-related complications such as exposure or extrusion following MUS placement. There are multiple case series, retrospective and prospective studies describing the many aspects of this complex clinical scenario. Most are focused on identifying and reporting functional outcomes through urodynamics and validated questionnaires. The indication prompting sling revision does often improve following the revision, but the issue may persist, and additional treatments may be required.SummaryDevelopment or resolution of any functional issues after MUS removal rely on the indication for removal, certain patient-specific factors, and the severity of symptoms prior to MUS removal. Although there is a significant number of studies concerning urethral sling removal management, more studies with a larger number of patients and more detailed data stratification are needed for addressing discreet functional outcomes after removal of mid-urethral sling.