Scholarlink

Introduction and Hypothesis <p>Midurethral sling (MUS) procedures are widely used for stress urinary incontinence (SUI), yet long-term outcomes remain incompletely characterized. This narrative review synthesizes evidence from studies with ≥10 years of follow-up, focusing on structural continence, patient-reported outcomes, late complications, and evolving storage symptoms.</p> Methods <p>A PubMed-based narrative review was conducted for studies published between January 1996 and March 2026 reporting ≥10-year outcomes after MUS. Randomized trials and observational studies were included. Outcomes included subjective and objective continence, reoperation rates, mesh-related complications, de novo overactive bladder (OAB), and quality of life. Given heterogeneity in design and outcome definitions, findings were synthesized qualitatively through thematic grouping, temporal trajectory analysis, and cross-study interpretative comparison.</p> Results <p>Seventeen studies with 10–25+ years of follow-up were included. Objective cure rates exceeded 85–90% at 10 years and remained stable in retropubic cohorts. Subjective cure rates were more variable and declined in some cohorts despite preserved objective outcomes. Long-term randomized data suggested comparable continence between retropubic and transobturator slings, although some favored retropubic approaches under stricter definitions. De novo OAB increased over time, reaching 41.6% at 20 years, while transobturator mesh exposure rates increased from 2.5% at 13 years to 10% at 17 years. Patient-reported outcomes appeared increasingly influenced by storage symptoms, particularly de novo OAB, whereas the contribution of voiding dysfunction remained insufficiently characterized in the available literature.</p> Conclusions <p>MUS procedures provide durable long-term structural continence. However, patient-perceived outcomes may evolve due to storage symptoms, particularly de novo OAB, and late complications. Although voiding dysfunction may contribute to long-term symptom burden, its role remains insufficiently characterized in the available literature. Longitudinal, domain-specific assessment beyond binary continence measures is needed.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Long-Term Outcomes of Midurethral Slings: A Narrative Review of Objective and Patient-Reported Trajectories

  • 期刊论文

  • 发表日期：

    2026年7月23日

查看全文
  • Elif Nazli Cetindag,
  • Ahmet Ozgur Yeniel

摘要

Introduction and Hypothesis

Midurethral sling (MUS) procedures are widely used for stress urinary incontinence (SUI), yet long-term outcomes remain incompletely characterized. This narrative review synthesizes evidence from studies with ≥10 years of follow-up, focusing on structural continence, patient-reported outcomes, late complications, and evolving storage symptoms.

Methods

A PubMed-based narrative review was conducted for studies published between January 1996 and March 2026 reporting ≥10-year outcomes after MUS. Randomized trials and observational studies were included. Outcomes included subjective and objective continence, reoperation rates, mesh-related complications, de novo overactive bladder (OAB), and quality of life. Given heterogeneity in design and outcome definitions, findings were synthesized qualitatively through thematic grouping, temporal trajectory analysis, and cross-study interpretative comparison.

Results

Seventeen studies with 10–25+ years of follow-up were included. Objective cure rates exceeded 85–90% at 10 years and remained stable in retropubic cohorts. Subjective cure rates were more variable and declined in some cohorts despite preserved objective outcomes. Long-term randomized data suggested comparable continence between retropubic and transobturator slings, although some favored retropubic approaches under stricter definitions. De novo OAB increased over time, reaching 41.6% at 20 years, while transobturator mesh exposure rates increased from 2.5% at 13 years to 10% at 17 years. Patient-reported outcomes appeared increasingly influenced by storage symptoms, particularly de novo OAB, whereas the contribution of voiding dysfunction remained insufficiently characterized in the available literature.

Conclusions

MUS procedures provide durable long-term structural continence. However, patient-perceived outcomes may evolve due to storage symptoms, particularly de novo OAB, and late complications. Although voiding dysfunction may contribute to long-term symptom burden, its role remains insufficiently characterized in the available literature. Longitudinal, domain-specific assessment beyond binary continence measures is needed.