Stress Urinary Incontinence After Robotic Sacrocolpopexy with and Without Concomitant Midurethral Sling

Objective: The goal of this study was to compare the rates of stress urinary incontinence (SUI) in women who underwent robotic sacrocolpopexy (RSCP) with and or without a concomitant midurethral sling. Design: This was a retrospective multicenter cohort study. Materials and Methods: Women who underwent RSCP between November 2007 and January 2010 were placed into two groups: patients who had a concomitant sling with their surgery and those who had had robotic sacrocolpopexy alone. The decision to place a sling was based on the presence of a preoperative urodynamic stress incontinence or a positive result of a supine cough stress test. Outcome Measures: Outcomes were measured using validated condition-specific questionnaires. The primary outcome was any reported SUI at 3-6 months after surgery. Results: A total of 82 women were included in the study. The overall rate of postoperative SUI was 31.7%. Postoperative SUI was lower in patients who underwent RSCP with a concomitant sling, compared with those who underwent RSCP alone (18.6% versus 46.2%; relative risk: 0.4; 95% confidence interval: 0.2-0.8, p = 0.007). The number of slings needed to prevent 1 case of postoperative SUI was 3.6. Conclusions: Women who underwent RSCP alone reported a high rate of de novo SUI. Concomitant sling placement significantly reduced this risk.