Identification of the optimal time to treat urgency after a midurethral sling procedure for stress urinary incontinence

We followed 91 patients who had undergone transobturator tension-free vaginal tape procedure on their perioperative urgency symptom for 1 year to identify risk factors and optimal time to commence further treatment in the presence of postoperative urgency. Of the 59 patients with preexisting urgency, 54.2, 35.6, and 39.0% demonstrated symptom persistence at postoperative 1, 6, and 12 months, respectively. Of the 32 patients without preoperative urgency, 3.1 and 18.8% of patients demonstrated de novo urgency at 1 and 6 months, respectively, but symptom persistence to 12 months was observed in 6.2%. Overall, urgency lasting to 12 months was observed in 25 (27.5%) of the entire cohort. Preoperative urgency [p = 0.001, odds ratio (OR) 9.583] and urgency at 1 month (p = 0.001, OR 5.124) were associated with symptom persistence to 1 year after surgery. We recommend treatment if urgency is noted at 1 month postoperatively in patients with preexisting urgency, and after 6 months for those without preoperative urgency.