To determine the types and frequency of presenting symptoms in women undergoing sub-urethral mid-urethral sling removal (SSR) towards improving outcome reporting post-SSR.
Following IRB approval, women who underwent SSR of one MUS were evaluated for their presenting symptoms and correlation with the Urogenital Distress Inventory-Short form (UDI-6) questionnaire. Demographic data was recorded and patient-reported presenting symptoms were categorized into 5 domains: storage symptoms, voiding symptoms, pain, recurrent UTIs, or urinary incontinence (UI). The UDI-6 was reviewed preoperatively and at 6-12 months postoperatively. An ideal outcome, defined as resolution of incontinence, pain, resumption of sexual activity, and no need for further anti-incontinence procedures was also calculated.
From 2006-2017, 230 women met study criteria of whom 116 had UDI-6 questionnaires completed postoperatively. The majority of women (80%) had three or more presenting symptoms, with pain being the most common. The most common combination of symptoms was all five domains (46/230, 20%). Increasing number of symptoms was correlated with total preoperative UDI-6 score, and symptom domains were associated with their corresponding UDI-6 sub-domain questions. Domains not covered by UDI-6 i.e. recurrent UTIs and dyspareunia, accounted for 27% of reported symptoms. Due to limited data on sexual activity, an ideal outcome was reached in 10% of patients, but was at 40% once sexual activity information was excluded.
In this series, the presenting symptoms of women undergoing SSR were manifold. The UDI-6 questionnaire correlated with many of these complaints and may be used in outcome analysis in conjunction with self-reported symptoms.