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Lateral cut as management of late voiding dysfunction syndrome post sling: ‘more than a cut’ - video article

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Abstract

Introduction and hypothesis

The mid-urethral sling (MUS) is considered the gold standard for stress urinary incontinence (SUI). Nevertheless, this procedure is not excluded from postsurgical complications, which can be challenging for most clinicians. Hence, one of the main concerns about this procedure is late postoperative voiding dysfunction (LDS), defined as obstructive symptoms 6 weeks after surgery. Primary medical management regularly includes expectant management and rehabilitation, including the mid-urethral cut sling (MUCS) as an alternative when it fails. This video provides an anatomical illustration and detailed description of the surgical steps of the J-cut of the lateral sling.

Materials and methods

We set up a step-by-step surgical process and provided some advice for MUCS in a video; this material included how to position the sling, dissect, isolate the synthetic material, release adhesions and make a lateral cut of the MUS. Additionally, a case series of 30 patients from our institution is described to confirm the effectiveness of MUCS to manage delayed voiding dysfunction syndrome.

Results

MUCS in LDS was beneficial for our patients. Obstructive symptoms improved clinically from 75% to 100%, and urgency-related symptoms decreased from 57.9% to 26.3%, evidencing 20% SUI post-MUCS surgery.

Conclusions

The lateral cut of the mid-urethral tape should be considered a surgical alternative for the resolution of post-sling late voiding dysfunction syndrome in patients who do not improve with expectant management.

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Fig. 1

Abbreviations

MUS:

mid-urethral sling

TVT-R:

retropubic suburethral tape

TVT-O:

transobturator suburethral tape

SUI:

stress urinary incontinence

MUCS:

mid-urethral cutting sling

VD:

voiding dysfunction

LDS:

late voiding dysfunction syndrome post sling

J-cut:

lateral “J” cut

References

  1. Minassian VA, Drutz HP, Al-Badr A. Urinary incontinence as a worldwide problem. Int J Gynaecol Obstet. 2003;82(3):327–38. https://doi.org/10.1016/s0020-7292(03)00220-0.

    Article  CAS  PubMed  Google Scholar 

  2. Dmochowski RR, Blaivas JM, Gormley EA, Juma S, Karram MM, Lightner DJ, Luber KM, Rovner ES, Staskin DR, Winters JC, Appell RA. Female stress urinary incontinence update panel of the American Urological Association Education and Research, Inc, Whetter LE. Update of AUA guideline on the surgical management of female stress urinary incontinence. J Urol. 2010;183(5):1906–14. https://doi.org/10.1016/j.juro.2010.02.2369.

    Article  PubMed  Google Scholar 

  3. Baekelandt F, Van Oyen P, Ghysel C, Van der Aa F, Ampe J. Long-term functional results after unilateral mid-urethral sling transection for voiding dysfunction. Eur J Obstet Gynecol Reprod Biol. 2016;207:89–93. https://doi.org/10.1016/j.ejogrb.2016.10.020.

    Article  CAS  PubMed  Google Scholar 

  4. Cetinel B, Tarcan T. Management of complications after tension-free midurethral slings. Korean J Urol. 2013;54(10):651–9. https://doi.org/10.4111/kju.2013.54.10.651.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kasturi S, Hale DS. "J" cut of sling for postoperative voiding dysfunction following synthetic midurethral slings. Int Urogynecol J. 2011 Aug;22(8):933–6. https://doi.org/10.1007/s00192-011-1404-5.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Clínica Universitaria Colombia, Fundación Universitaria Sanitas (FUS), Cra. 66 #23 - 46, Bogotá, Colombia

    Juan D. Solarte

  2. Hospital de San José, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia

    Carlos A. Diaz

  3. Hospital de San José, Hospital Infantil de San José, Fundación Universitaria de ciencias de la Salud (FUCS), Bogotá, Colombia

    Carlos A. Beltran

Authors
  1. Juan D. Solarte
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  2. Carlos A. Diaz
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  3. Carlos A. Beltran
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Contributions

J. Solarte: Protocol, Data collection, Project development, Data analysis, Manuscript writing, Editing.

CA Díaz: Protocol, Project development, Data analysis, Manuscript writing.

CA Beltran: Data analysis, Editing.

Corresponding author

Correspondence to Juan D. Solarte.

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Written consent was read, understood, and voluntarily signed by all patients to publish this video article and accompanying images.

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None.

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Solarte, J.D., Diaz, C.A. & Beltran, C.A. Lateral cut as management of late voiding dysfunction syndrome post sling: ‘more than a cut’ - video article. Int Urogynecol J 33, 741–744 (2022). https://doi.org/10.1007/s00192-021-04993-7

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  • DOI: https://doi.org/10.1007/s00192-021-04993-7

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