Mid-urethral sling with proper sling tension is an effective treatment for stress urinary incontinence in women after pelvic radiotherapy: a pilot study of case series.

Background: At present, consensus on the management of female stress urinary incontinence (SUI) after pelvic radiotherapy is lacking. We aim to assess the clinical effects of mid-urethral sling (MUS) for the treatment of SUI after pelvic radiotherapy in women.

Methods: We conducted a retrospective review of the clinical database of female with SUI after pelvic radiotherapy from June 2015 to February 2022. The clinical efficacy was evaluated by International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF) questionnaire, maximum flow rate (Qmax) and postvoid residual (PVR) urine. All patients were reviewed postoperatively in an outpatient clinic.

Results: We identified 26 patients with mean age of 59.35 ± 7.32 years. All the patients who suffered from SUI had a history of gynaecological malignancies and received pelvic radiotherapy. 21 patients (80.77%, 95% CI: 0.621-0.915) were considered to have successfully improved after surgery, the ICI-Q-SF scores were lower than the pre-operative at 2 weeks, 6 months and 1 year postoperatively (P < 0.01). After 1-year follow-up, none of the patients had mesh erosion.

Conclusion: SUI following radiotherapy for the treatment of pelvic malignancy can be challenging to manage. MUS is a highly effective and safe option for the treatment of SUI after radiotherapy, additionally, that proper sling tension is the key to the success of the procedure.