Stress Urinary Incontinence Procedure Outcomes in the < 40-Year-Old Population: A Multicenter Study.

Abstract

Objectives: Stress urinary incontinence (SUI) is a common problem affecting the quality of life of many women, but treatment outcomes in younger women are sparsely reported. We sought to evaluate SUI procedure outcomes in women < 40 years old.

Methods: We conducted a multicenter retrospective cohort study of women < 40 years old who underwent a primary SUI procedure between January 1, 2020 and July 1, 2023. We compared outcomes and complication rates of midurethral slings to periurethral bulking with polyacrylamide hydrogel (PAHG). Data was extracted by manual chart review and analyzed using descriptive statistics, comparative statistics with chi-square or Fisher exact tests, or the Wilcoxon two sample test for continuous measurements. The primary outcome was report of cure or improvement in SUI symptoms.

Results: Fifteen study sites were included, with individual IRB approvals obtained at each site. A total of 377 women < 40 years old were identified who underwent a primary SUI procedure during the study period; 40 underwent periurethral bulking with PAHG and 337 underwent sling (307 (91%) retropubic, 13 (4%) transobturator, 17 (5%) single incision). Baseline demographics were similar between groups. Reported rates for cure or improved symptoms were 88.6% (n = 31/35) for PAHG and 97.8% (n = 315/324) for slings (p = 0.0156) at 4 weeks and 81.8% (n = 9/11) for PAGH and 92.9% (n = 66/71) for slings at approximately 1 year postoperative (p = 0.131). Complication rates were low in both groups.

Conclusions: Women < 40 years old who received periurethral bulking with PAHG for treatment of SUI had lower rates of cure/improvement at short-term follow-up in their SUI compared to those who received a sling.