What outcomes indicate a successful midurethral sling procedure?

• A. Reduced leakage episodes, improved quality of life, decreased pad use, and a negative cough test.
• B. Increased leakage with coughing.
• C. No change in symptoms but patient reports satisfaction.
• D. Positive cough test.

Answer: (A)

A successful midurethral sling outcome means the patient experiences less leakage and better urinary control in daily life, supported by objective signs. When leakage episodes drop, pad use decreases, and quality of life improves, it shows the sling is effectively supporting the urethra. The cough test adds an objective check: a negative result means no leakage occurs with coughing, indicating restored continence during a common stress trigger. Together, these elements reflect both how the patient feels and how the bladder is behaving under stress.

The other scenarios point to ongoing problems—more leakage with coughing means the stress incontinence persists; no symptom change with patient satisfaction could arise from non-urinary factors or unmet expectations despite limited improvement; a positive cough test directly shows leakage during coughing, signaling a lack of continence after the procedure.