The Polypropylene Pubovaginal Sling for the Treatment of Recurrent Stress Urinary Incontinence

Morgan, J. Edwin; Heritz, Dianne M.; Stewart, Fiona; Connolly, J.; Farrow, G.A.

doi:10.1016/s0022-5347(01)66961-1

Cited by 63 publications

(27 citation statements)

References 7 publications

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“…The recurrence of symptoms, when present, usually occurs in the first six months, and is usually secondary to the degeneration of the strip or loss of the sutures. After this period the success of the surgery is known to last for many years (8,9). The mean follow-up of our patients was 24.8 ± 7.1 months (3 -38 months).…”

Section: Discussionmentioning

confidence: 80%

Pubovaginal sling in the treatment of stress urinary incontinence for urethral hypermobility and intrinsic sphincteric deficiency

et al. 2003

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Purpose: This study was undertaken to evaluate the use of pubovaginal sling for the treatment of female stress urinary incontinence in patients with intrinsic sphincteric deficiency and patients with urethral hypermobility.Materials and Methods: Sixty-two patients aging 22 to 73 years-old (mean = 49.6) with a median parity of 4.1 (range 0 -14) who underwent pubovaginal autologous fascial sling procedures for stress urinary incontinence from August/1999 to August/2002 were prospectively analyzed. Objective pre and postoperative urodynamic evaluation was performed in all cases. The patients were divided into 2 groups: thirty-nine patients (62.9%) with urethral hypermobility (Valsalva leak point pressure equal or superior to 60 cm of H 2 O) and twenty-three patients (37.1%) with intrinsic sphincteric insufficiency (Valsalva leak point pressure below 60 cm of H 2 O).Results: The average follow-up period was 24.8 months, ranging from 3 to 38 months. Three patients (4.8%) had detrusor overactivity before the operation, and 36 patients (58.1%) had voiding dysfunction before surgery. The postoperative objective cure rate was 88.7% for stress urinary incontinence. The study also showed that 32.2% of the patients had voiding dysfunction and 11.3% had detrusor overactivity. The mean hospital stay was 3.1 days (range 2 -4). No difference in the above parameters was noticed between patients with intrinsic sphincteric deficiency and those with urethral hypermobility.Conclusion: Construction of a pubovaginal sling is an effective technique for the relief of severe stress urinary incontinence, for both patients with urethral hipermobility and with intrinsic sphincteric deficiency, having a cure rate of 88.7%. The high frequency of postoperative voiding urgency was not related to the detrusor overactivity as evaluated by urodynamic studies.

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Section: Discussionmentioning

confidence: 80%

Pubovaginal sling in the treatment of stress urinary incontinence for urethral hypermobility and intrinsic sphincteric deficiency

et al. 2003

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“…15 Norris et al indicated that when care was taken to minimize the amount of synthetic material, reduce total operative time and limit exposure of the material to the operative field, female stress incontinence could be treated effectively with synthetic material with an acceptably low complication rate. 16 They used the same material as we did and emphasized that this procedure could be minimally invasive, cost-effective and well tolerated.…”

Section: Discussionmentioning

confidence: 99%

Polytetrafluoroethylene patch sling for type 2 or type 3 stress urinary incontinence

et al. 2001

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Background: Surgical success rates and complications of anti-incontinence surgery were evaluated according to the type of stress incontinence and the type of surgery. Methods: From 1989 to 1998, we treated 137 women for stress urinary incontinence with antiincontinence surgery. Of the 137 patients, 110 had type 2 stress urinary incontinence and 27 had type 3 stress urinary incontinence. Of 110 patients with type 2 stress urinary incontinence, 57 underwent pubovaginal sling procedure and 53 were treated with the Gittes procedure. All of the patients with type 3 stress urinary incontinence underwent the pubovaginal sling procedure. Results: Cure rates with the pubovaginal sling procedure were 82% in type 2 incontinence and 70% in type 3 incontinence. Cure rates with the Gittes procedure were 56%. The occurrence of de novo urge symptom and pelvic pain was low and bore no relation to either operative method or type of stress incontinence. Conclusions:The pubovaginal sling procedure using the polytetrafluoroethylene patch was effective for type 2 or 3 stress urinary incontinence.

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“…Most of the patients with any type of SUI treated after 1996 received the pubovaginal sling procedure either using rectus fascia or polypropylene mesh. All the surgical procedures were performed as described previously [1,4,5,11,12,19]. In the Gittes and Raz BNS procedures the supporting site was placed at the bladder neck and proximal urethra.…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have documented the long-term effectiveness of the sling procedure and recommended that it be used as the first-line treatment for all types of SUI [10][11][12]. The sling procedure has also been recommended as the treatment of choice for both intrinsic sphincteric deficiency (ISD) and for failed anti-incontinence surgery, suggesting that it may provide a cure for any kind of SUI at a single procedure [13,14].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Results of Surgical Treatment for Female Stress Urinary Incontinence

Kuo

2001

Urol Int

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Objective: To compare the long-term success rates of bladder neck suspension (BNS) and pubovaginal sling procedure in different types of female stress urinary incontinence (SUI) in order to identify appropriate treatment strategies for SUI. Methods: A total of 157 women who received anti-incontinence surgery were followed-up for a mean period of 58.1 ± 33.9 months. The surgical outcome was analyzed and was compared among the different types of SUI and among BNS and pubovaginal sling procedures. Results: SUI was classified as type I in 16 patients, type II in 111 patients, and type III in 34 patients. Surgical procedures included Gittes BNS (n = 62), Raz BNS (n = 53), and pubovaginal sling procedure (n = 42). The total success rate was 77.1%, including a 38.2% cure rate and a 38.9% significantly improved rate. Analysis of the results revealed that type III SUI had the lowest success rate (67.6%), while the pubovaginal sling procedure had the best success (93.9%) and cure rates (54.8%). The success rates of BNS were significantly lower than that of pubovaginal sling in type III SUI, less favorable in type II SUI, but remained high in type I SUI. 75% of patients with treatment failure had recurrence within the fist postoperative year. Conclusions: In this series of patients, the long-term cure rates of anti-incontinence surgeries are not satisfactory. BNS procedures had satisfactory results only in type I SUI while the pubovaginal sling procedure had better results in both types II and III SUI. The pubovaginal sling procedure might have better long-term results in the treatment of all types of SUI.

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The Polypropylene Pubovaginal Sling for the Treatment of Recurrent Stress Urinary Incontinence

Abstract: The 2-team polypropylene (Marlex) mesh approach continues to be an effective treatment for women with complicated stress urinary incontinence.

Cited by 63 publications

References 7 publications

Pubovaginal sling in the treatment of stress urinary incontinence for urethral hypermobility and intrinsic sphincteric deficiency

Pubovaginal sling in the treatment of stress urinary incontinence for urethral hypermobility and intrinsic sphincteric deficiency

Polytetrafluoroethylene patch sling for type 2 or type 3 stress urinary incontinence

Long-Term Results of Surgical Treatment for Female Stress Urinary Incontinence

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