Effects of pubovaginal sling procedure on patients with urethral hypermobility and intrinsic sphincteric deficiency: would they do it again?

Academic Article

Abstract

  • OBJECTIVE: This study was undertaken to assess the cure rate of stress urinary incontinence, long-term effects on other lower urinary tract symptoms, and quality of life in a cohort of patients who underwent pubovaginal sling procedures for treatment of incontinence related to intrinsic sphincteric deficiency and urethral hypermobility. STUDY DESIGN: This was a retrospective analysis of 57 patients with 90% follow-up who underwent pubovaginal autologous fascial sling procedures for stress urinary incontinence related to urethral hypermobility and intrinsic sphincteric deficiency. Objective postoperative urodynamic evaluation was performed in 34 (60%) of the cases. Telephone interviews to assess quality-of-life parameters were performed in all cases. RESULTS: The mean follow-up period was 42 months and the median follow-up period was 34 months, with a range of 0.5 to 134 months. The age at the time of the sling procedure ranged from 18 to 84 years, with a median parity of 3.0 (range, 0-6). Preoperative body mass index ranged from 19.5 to 39.1 kg/m(2). Five percent of patients had detrusor instability before the operation. Forty-one percent (41%) of the patients who underwent postoperative urodynamic evaluation had voiding dysfunction. The postoperative objective cure rate for stress urinary incontinence was 97%. Of all patients 88% indicated that the sling had improved the quality of life, 84% indicated that the sling relieved the incontinence in the long-term, and 82% would choose to undergo the procedure again. CONCLUSION: Construction of a pubovaginal sling is an effective technique for relief of severe stress urinary incontinence. Voiding dysfunction is a common side effect. Despite this problem, a significant number of patients would elect to undergo the procedure again.
  • Authors

    Keywords

  • Adolescent, Adult, Aged, Aged, 80 and over, Fascia Lata, Fasciotomy, Female, Humans, Middle Aged, Patient Satisfaction, Pubic Bone, Quality of Life, Retrospective Studies, Surgical Flaps, Treatment Outcome, Urethra, Urinary Bladder, Urinary Incontinence, Stress, Urination Disorders, Urodynamics, Urologic Surgical Procedures, Vagina
  • Digital Object Identifier (doi)

    Author List

  • Richter HE; Varner RE; Sanders E; Holley RL; Northen A; Cliver SP
  • Start Page

  • 14
  • End Page

  • 19
  • Volume

  • 184
  • Issue

  • 2