Pubovaginal sling with a low-cost polypropylene mesh

Rodrigues, Fransber Rondinelle Araújo; Filho, Romulo Maroccolo; Maroccolo, Roberto R.; Paiva, Lucio C.; Diaz, Fernando Augusto Ferreira; Ribeiro, Elissa

doi:10.1590/s1677-55382007000500011

Cited by 9 publications

(9 citation statements)

References 18 publications

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“…A higher number of patients in their sixth decade of life were observed in both groups, as described in other studies (17,18). This finding confirms the predominance of the disease in Outcomes of the hand made sling 21 patients submitted to sling surgery, the frequency of postoperative temporary voiding difficulties was 28.6% (21).…”

Section: Discussionsupporting

confidence: 86%

“…Despite the short postoperative follow-up (90 days) in the present study, investigations using the same material and a longer follow-up of 13 months (18), 15 months (24) and 23 months (17) reported similar cure rates of SUI or improvement of clinical symptoms (95%, 96% and 89%, respectively). These results demonstrate the long-term efficacy of a cost-effective hand-made polypropylene mesh sling for the treatment of SUI.…”

Section: Discussionmentioning

confidence: 41%

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Comparison of the outcomes of the sling technique using a commercial and hand-made polypropylene sling

Brito¹,

Sousa²,

Neto³

et al. 2011

Int. braz j urol.

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Purpose: To compare the outcomes and costs of stress urinary incontinence (SUI) surgery using a hand-made sling (Marlex®) versus a commerciallyavailable suburethral polypropylene sling (Advantage®). Materials and Methods: Thirty-nine women with SUI due to bladder neck hypermobility and/or sphincter incompetence diagnosed by clinical examination and urodynamic studies were divided into two groups: group 1 (n = 19) consisted of patients from an academic center (Department of Urology, University Hospital of Federal University of Maranhao, and group 2 (n = 20) patients from private practice. The hand-made polypropylene suburethral sling was used in group 1 and the commercial sling in group 2. The patients were evaluated 30, 60 and 90 days after surgery. Results: The mean duration of surgery was 43 min. in group 1 and 51 min. in group 2. No postoperative voiding difficulties were observed in group 1 (100%), as well as, in 94.7% of patients of group 2. A bladder catheter was not required in any of the patients of the two groups at the end of the study. The level of satisfaction was 100% in group 1, whereas, one patient of group 2 considered the surgery to be unsuccessful. Urodynamic studies showed low amplitude uninhibited contraction in 11.1% of patients of group 1 and 10.5% of group 2. No complications were observed in either group. Conclusion: The hand-made polypropylene mesh (Marlex®) can be used for sling procedures, saving costs and yielding results similar to that obtained with commercial sling systems.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 41%

Comparison of the outcomes of the sling technique using a commercial and hand-made polypropylene sling

Brito¹,

Sousa²,

Neto³

et al. 2011

Int. braz j urol.

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“…There was no infection or erosion. Rodrigues et al [25] evaluated a pubovaginal sling using STM in 118 women. At a mean follow-up of 42 months there were three vaginal extrusions of the mesh, 81.3% of the patients were considered cured, whilst 9.3% had a significant improvement.…”

Section: Discussionmentioning

confidence: 99%

Use of surgeon-tailored polypropylene mesh as a needle-less single-incision sling for treating female stress urinary incontinence: Preliminary results

ElSheemy

Ghamrawy

Fathy

et al. 2015

Arab Journal of Urology

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ObjectiveTo evaluate the safety and efficacy of a procedure using surgeon-tailored polypropylene mesh (STM) through a needle-less single-incision technique for treating stress urinary incontinence (SUI), aiming to decrease the cost of treatment, which is important in developing countries.Patients and methodsIn all, 43 women diagnosed using a cough stress test were treated from January 2011 to June 2013 at the Urology and Gynaecology Departments (dual-centre), Cairo University Hospitals. Previous surgery was not a contra-indication. Patients with a postvoid residual urine volume of >100 mL, a bladder capacity of <300 mL, impaired compliance or neurological lesions were excluded. The Stress and Urge incontinence Quality of life Questionnaire (SUIQQ) and urodynamic variables were compared before and after surgery. The variables were compared between the baseline and postoperative follow-up values using a paired t-test, a Wilcoxon signed-rank test or McNemar’s test.ResultsThe mean age was 42.7 years and 20 (47%) patients had associated urgency UI (UUI), whilst 21 (49%) had intrinsic sphincter deficiency. The median (range) operative duration was 14 (5–35) min. There were no complications during surgery. The mean (SD, range) follow-up was 28.1 (5.1, 18–36) months. Postoperative complications were vaginal discharge (5%), failure of wound healing (5%), dyspareunia (5%) and UTI (5%). The sling was removed in one case. SUI, UUI and quality-of-life indices improved significantly after surgery. There were no significant differences in pressure-flow studies before and after surgery. In all, 38 (88%) patients were cured, four (9%) improved and in one only the treatment failed (2%).ConclusionThis technique is simple, safe, effective, reproducible and economical for treating SUI. The STM was easy to insert in a short operation.

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“…Haab et al (19), with 4 years of follow-up of a pubovaginal sling for the treatment of SUI for intrinsic sphincter insufficiency and using an self-assessed questionnaire, confirmed the high satisfaction rate of the patients, in spite of their symptoms of urinary urgency. Rodrigues et al (20), using polypropylene mesh for the construction of sling for SUI, concluded that the complications and cure rates can be compared with TVT, and should be (22) carried out a comparative histological study of sling materials in women who underwent the repair, in which a portion of the sling was removed in order to analyze the inflammatory response, encapsulation, neovascularization, and fibroblastic infiltration. The tissues analyzed were polypropylene, aponeurosis (autologous fascia), pig fascia, and fascia from cadavers.…”

Section: Commentsmentioning

confidence: 99%

Comparative study of polypropylene and aponeurotic slings in the treatment of female urinary incontinence

et al. 2010

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Purpose: Female stress urinary incontinence (SUI), the involuntary leakage of urine, is a highly prevalent social and hygiene problem, and various surgical techniques have been developed to correct it. This study used the technique of an aponeurosis sling made from the rectus abdominis muscle as a standard and compared the technique to a sling made with a polypropylene mesh, (Marlex®). Materials and Methods: From 2000 to 2007, 158 women who underwent surgery for SUI with an aponeurosis sling, (average age 55 years), were used as a standard for comparison with 316 women who underwent surgery with a polypropylene sling (average age 55 years). Results: The mean follow-up period was 3.65 and 3.56 years for the respective groups. The aponeurosis group showed a cure of SUI in 128 (81.0%), improvement in 23 (14.6%), and failure in 7 (4.4%). The polypropylene group showed a cure in 281 (88.9%), improvement in 23 (7.3%), and failure in 10 (3.2%) (p = 0.083). Urgency was observed in 19 (12%) of the aponeurosis group, and 28 (8.9%) in the polypropylene group (p = 0.320).Conclusions: This study showed that the polypropylene mesh is an effective alternative to construct a sling for SUI in women. The results and rates of complication were comparable to the fascial sling from the rectus abdominis muscle aponeurosis.

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Pubovaginal sling with a low-cost polypropylene mesh

Abstract: The construction of a pubovaginal sling using a low-cost polypropylene mesh is a safe and effective technique for the relief of SUI. It should be considered an alternative, especially for patients in public health systems with low financial resources.

Cited by 9 publications

References 18 publications

Comparison of the outcomes of the sling technique using a commercial and hand-made polypropylene sling

Comparison of the outcomes of the sling technique using a commercial and hand-made polypropylene sling

Use of surgeon-tailored polypropylene mesh as a needle-less single-incision sling for treating female stress urinary incontinence: Preliminary results

Comparative study of polypropylene and aponeurotic slings in the treatment of female urinary incontinence

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