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Changes in the Bladder Micro-environment Following Midurethral Sling Surgery for Stress Urinary Incontinence

Conditions
Stress Urinary Incontinence
Interventions
Device: Retropubic midurethral sling
Registration Number
NCT03942549
Lead Sponsor
Oregon Health and Science University
Brief Summary

This observational cohort study is aimed at determining changes in the cytokine expression profile as well as the urinary and vaginal microbiome of women undergoing midurethral sling placement for the treatment of stress urinary incontinence.

Detailed Description

Primary Objectives:

This is a pilot study to evaluate how midurethral sling (MUS) placement for the treatment of stress urinary incontinence (SUI) affects the bladder microenvironment, specifically the local microbial community or "microbiome" of the bladder and the cytokine expression profile. The investigators also aim to correlate any changes in the microbiome or cytokine expression profile with patient-reported urinary symptoms preoperatively and postoperatively.

Specific Aim 1: Assess the change in the urinary and vaginal microbiome (preoperatively to postoperatively) in women undergoing MUS placement for the treatment of SUI. The investigators hypothesize that the bladder environment will be disturbed by surgery involving the lower urinary tract and will show demonstrable changes in the urinary and vaginal microbiota.

Specific Aim 2: Characterize the cytokine profile of the bladder (preoperatively to postoperatively) in women undergoing MUS placement for the treatment of SUI. The investigators hypothesize that MUS treatment will change the cytokine profile of the bladder and lead to alterations in the expression of pro-inflammatory cytokines.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Female
Target Recruitment
20
Inclusion Criteria
  • Age > 18 years old
  • Planning to undergo retropubic midurethral sling placement
Exclusion Criteria
  • Prior surgery for stress urinary incontinence
  • Untreated pelvic organ prolapse > Stage II based on POP-Q assessment
  • Concomitant surgery for prolapse
  • Current use of anticholinergic medications
  • Use of systemic or vaginal antibiotics in the last 2 months
  • Active urinary tract infection
  • History of recurrent UTI
  • Pregnancy
  • History of pelvic radiation or bladder cancer

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
MUS CohortRetropubic midurethral slingThis cohort will undergo midurethral sling placement.
Primary Outcome Measures
NameTimeMethod
Urinary MicrobiomeSix weeks

change in the relative abundance of urinary lactobacillus between baseline, 2 and 6 weeks postoperative

Secondary Outcome Measures
NameTimeMethod
Prevalence of overactive bladder symptomsSix weeks

Validated symptom questionnaires will be collected at baseline and again at 2 and six weeks postoperatively to assess common symptoms associated with overactive bladder.

Trial Locations

Locations (2)

Legacy Good Samaritan Hospital

🇺🇸

Portland, Oregon, United States

Oregon Health & Science University

🇺🇸

Portland, Oregon, United States

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