The completely dry rate: A critical re-evaluation of the outcomes of slings

Objective: To critically evaluate sling outcomes and revisit the realistic goals of anti-incontinence surgery. Materials and Methods: A review of an Institutional Review Board-approved prospective database revealed the outcomes of four different sling techniques that are utilized at our institution. Results: Four hundred ninety-eight patients had a mean follow-up varying from 9 to 24 months (range 6-50) after undergoing one of four different sling techniques utilized at our institution. The techniques had similar results with regard to completely dry rate, overall success rate, and rate of urgency regardless of the variation in follow-up time. Success was defined as completely dry or leakage =1/week or =70% improved by questionnaire in those patients who leaked 1/week. Success, by this definition, varied from 74.9% to 85.7%, but the completely dry rate varied from 36.1% to 45.2%. An additional 31.0% to 33.3% leaked =1/week, and of the remaining patients, 24.5% to 44.4% considered themselves =70% improved despite leakage >1/week. Urge incontinence was reported by 24.4% to 33.3% of patients. Conclusion: As surgeons, we must constantly reevaluate the outcomes and purposes of the procedures we perform on our patients.