Introduction: To develop a modified Delphi consensus statement regarding the surgical timing in patients with retention/dysuria after mid-urethral sling. Methods: A Systematic review of Pubmed, Embase and Scopus was performed to evaluate the available evidence on the best surgical timing in patients with retention/dysuria after mid-urethral sling. Overall, only 4 studies with poor evidence were identified, therefore a consensus statement was performed. Four rounds of Delphi were performed and final statements were submitted anonymously using Survey Monkey. All statements were voted on a 1 to 10 scale. In order to approve the statement consensus should be >80%. In case of a consensus between 60 and 80% the statement was discussed by all the members of the consensus and submitted again in a fourth round. Results: Overall, four studies were identified evaluating the best surgical timing in patients with retention/dysuria after mid-urethral sling. No randomized clinical trials were retrieved, and the level of evidence was low. In the first round based on four expert opinion and on the evidence retrieved four statements were developed. On round two a group of ten experts discussed and modified the statements to avoid redundancy and improve readability before submitting it to the expert panel resulting in two final statements. On round three the statements (Table 1) were submitted to 40 experts which voted the statements. One statements needed a round four and reached consensus after discussion. Results of the consensus are written in table 1. Statement Agreement Round 3 Agreement Round 4 Early surgical treatment of urinary retention / dysuria after MUS should be preferred 85% Timing of surgical treatment of retention/dysuria after MUS depends on the severity of the urinary retention / dysuria 79% 90% Conclusions: The present consensus statement answers some unmet needs on the right timing of surgical treatment of retention/dysuria after MUS. The lack of evidence in this setting warrants well designed clinical trials to answer these questions. SOURCE OF Funding: No one
