To report very long-term outcomes of E-SISTEr participants at one tertiary care center who underwent Burch (B) or Fascia sling (S) for stress urinary incontinence (SUI).

Following IRB approval, E-SISTEr participants at one center who had mid-term office evaluation in 2010 were further re-evaluated for longer term follow-up via office visits and structured telephone interviews. The phone interviews were conducted by a third party not involved in patient care for those not seen in the last 2 years. Both groups received validated questionnaires: Urogenital Distress Inventory-Short Form (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7), visual analog quality of life score (QoL). Failure was measured by Kaplan-Meier curve using time to reoperation for SUI.

Of 29 eligible patients (B=14, S=15), 21 had long-term information (B=11, S=10) with median follow-up of 15.1 years (range: 11.2-16.0). Of 8 lost to follow-up, 1 was deceased and 7 were unreachable by phone. UDI-6 Q#3 score was lower for those followed up by phone (n=13 [B=6, S=7] mean=0.3 ± 0.6) compared to those seen in clinics (n=8 [B=5, S=3] mean=1.3 ± 1.1) ( p=0.0208). UDI-6 scores were similar for Burch vs. Sling. SUI reoperation was reported in 3 patients (B=2, S=1): fascial sling (B=1), injectable agents (B=1, S=1). The overall Kaplan-Meier 15-year reoperation free survival rate was 85.2% (95% CI: 60.8%-95%).

In this well characterized cohort with median follow-up 15.1 years, there was sustained improvement in continence scores and quality of life related to SUI in both groups, with low reoperation rates.

The Journal of urology. 2019 Jun 28 [Epub ahead of print]

Amy Kuprasertkul, Alana L Christie, Gary E Lemack, Philippe Zimmern

UT Southwestern Medical Center , Dallas , Texas.