Success of Concomitant Versus Interval Slings for Prevention and Treatment of Bothersome de Novo Stress Urinary Incontinence

Jocelyn J. Fitzgerald, Alex Soriano, Joseph Panza, Tanya P. Hoke, Shweta P. Desai, Amanda M. Artsen, Sarah E. Andiman, Danielle D. Antosh, Robert E. Gutman

Research output: Contribution to journalArticlepeer-review


Background: Despite large trials designed to guide management on whether to perform a prophylactic continence procedure at the time of pelvic organ prolapse (POP) repair, it remains unclear if a staged or interval approach confers advantages in treatment of bothersome stress urinary incontinence (SUI) in women without bothersome SUI before their POP repair. Objective: The objective of this study was to compare success of concomitant versus interval slings for the prevention/treatment of de novo bothersome SUI after POP repair. Study Design: This multicenter retrospective cohort with prospective follow-up enrolled women with minimal or no SUI symptoms who underwent minimally invasive apical surgery for stage 2 or higher POP between 2011 and 2018 and had a concomitant sling placed at the time of POP surgery or an interval sling placed. Prospectively, all patients were administered the Urogenital Distress Inventory Short-Form 6, the Patient Global Impression of Improvement, and questions on reoperation/retreatment and complications. Results: A total of 120 patients had concomitant slings, and 60 had interval slings. There were no differences in the proportion of patients who had intrinsic sphincter deficiency (22% vs 20%), although the concomitant sling group was more likely to have a positive cough stress test result (30% vs 8%, P = 0.006). The interval sling group was more likely to report “yes” to SUI symptoms on Urogenital Distress Inventory Short-Form 6 (3% vs 30%, P = 0.0006) and during their postoperative visit (0% vs 24%, P < 0.0001). There were no differences in surgical complications. Conclusions: Among women with minimal or no SUI symptoms undergoing prolapse repair, concomitant slings resulted in lower rates of bothersome SUI compared with similar women undergoing interval sling placement.

Original languageEnglish (US)
Pages (from-to)194-200
Number of pages7
JournalFemale Pelvic Medicine and Reconstructive Surgery
Issue number4
StatePublished - Apr 1 2022


  • female pelvic reconstructive surgery
  • midurethral sling
  • pelvic organ prolapse
  • stress urinary incontinence
  • urinary incontinence
  • Suburethral Slings/adverse effects
  • Prospective Studies
  • Humans
  • Male
  • Treatment Outcome
  • Urinary Incontinence, Stress/etiology
  • Female
  • Pelvic Organ Prolapse/complications
  • Retrospective Studies

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynecology
  • Surgery


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