Peer-reviewed veterinary case report
Long-term safety of mid-urethral sling for urinary incontinence
By Fábián-Kovács R et al.·2025·Medical School·View original on Europe PMC →
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Original publication title: Long-Term Safety and Efficacy of Partially Absorbable Transobturator Mid-Urethral Sling in Women Aged 65 Years and Older.
Plain-English summary
This study looked at the safety and effectiveness of a specific surgical procedure called the Serasis partially absorbable mid-urethral sling in women aged 65 and older who experience stress urinary incontinence, which is when they leak urine during activities like coughing or exercising. Researchers compared the outcomes of 375 women, some younger and some older, over an average follow-up period of about 8.5 years. They found that while the elderly women had slightly higher rates of issues like difficulty urinating and overactive bladder after surgery, most were still very satisfied with the results. Overall, the surgery was considered safe, with very few complications related to the mesh used, and it worked well for both age groups. In conclusion, this surgical option is effective and has a low risk of long-term problems for older women dealing with this condition.
Abstract
<b>Objectives:</b> To assess the long-term safety and efficacy of the Serasis<sup>®</sup> partially absorbable transobturator mid-urethral sling (MUS) in women aged ≥65 years compared to younger women. <b>Methods:</b> A retrospective comparative study of 375 consecutive women who underwent Serasis<sup>®</sup> MUS for stress urinary incontinence (SUI). Patients were stratified into two age groups: 45-64 years (N = 118) and ≥65 years (N = 257), with further subdivision of the elderly cohort into 65-74 years (N = 208) and 75-84 years (N = 49). Primary outcomes included perioperative safety and long-term subjective cure rates, assessed via standardized telephone survey at a mean follow-up of 8.5 years (range, 6.8-10.9 years). <b>Results:</b> Perioperative outcomes were comparable across age groups. At 4 months postoperatively, subjective cure was achieved in 82.9% of elderly and 86.4% of younger patients. Long-term subjective cure rates were 79.6% and 85.4%, respectively (<i>p</i> = 0.27). Elderly patients experienced higher rates of postoperative voiding dysfunction and persistent overactive bladder symptoms, though subjective satisfaction remained high. Long-term mesh-related complications were infrequent across age groups. Specifically, vaginal mesh erosion requiring surgical removal occurred in three elderly patients (1.6%) and in only one younger patient (1.1%). A multivariate logistic regression analysis identified preoperative mixed urinary incontinence, BMI >30 kg/m<sup>2</sup> and concomitant pelvic organ prolapse repair as independent predictors of surgical failure. Age ≥65 years was not an independent predictor of surgical failure (OR 1.3, 95% CI 0.8-2.1, <i>p</i> = 0.31). <b>Conclusions:</b> The use of a partially absorbable MUS in elderly women with SUI is a safe and effective surgical approach, associated with a significant reduction in long-term mesh-related complications.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41464740