Recommendation ID
CG171/5
Question
Predictors of tape failure:- What are the effects of the following predictors on tape failure?
- Age per decade
- Lower maximum urethral closure pressure
- Secondary surgery versus primary surgery
- Higher maximal flow rate
- Concurrent pelvic organ prolapse surgery
- Nocturia versus no nocturia
- Urgency versus no urgency
- Pad weight (per 10 g)
 Previous urinary incontinence surgery versus no surgery
 Q-tip maximum straining less than 30 degrees, yes versus no
 Urge score (per 10 points)
 Urgency symptoms versus no urgency symptoms
 More than 20 procedures for each surgeon versus first 10 procedures for each surgeon
 General anaesthesia versus local anaesthesia
 BMI over 35 versus 30 or less
 Maximum urethral closure pressure of 31 or more versus 30 or less
 Primary surgery versus secondary surgery
 Preoperative anticholinergic medication use versus no use
Any explanatory notes
(if applicable)
Why is this important:- The factors identified for this research question are thought anecdotally by surgeons to have an impact on the outcome of tape surgery but there is little robust evidence in the literature. Certain patient factors such as older age and increased weight are thought to produce a higher chance of recurrent symptoms. Similarly, the effect of previous incontinence surgery, concomitant prolapse surgery and the 'learning curve' of the surgeon are all thought to have adverse effects on outcome (including an increased chance of urgency incontinence). In addition there is little robust evidence regarding the effect of previous urgency incontinence, higher maximum flow rates, nocturia or preoperative use of anticholinergics on the occurrence of post-operative urgency and bladder overactivity. It would be useful to be able to individualise treatment by understanding these risks in more detail.

Source guidance details

Comes from guidance
Urinary incontinence in women: management
Number
CG171
Date issued
September 2013

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 08/10/2013