Vaginal nylon sling: loop length and surgical outcomes in those with urethral hypermobility and intrinsic sphincter deficiency.
Fifty-four women with stress incontinence underwent a vaginal nylon sling procedure. Of these, 15 were diagnosed as having type I, 27 as type II, and 12 as type III genuine stress incontinence. Follow-up averaged 25 months (range 6-42). The total suture length prior to ligation, which supports the bladder neck with no tension, varied from 200 to 313 mm and demonstrated weak correlation with body mass index (R2 = 0.076, P = 0.043) and body weight (R2 = 0.082, P = 0.036). The objective success rate was 89% (48 of 54 patients) 25 months later; the subjective rate was 93% (50 of 54 patients). Kaplan-Meier analysis demonstrated that the cumulative continence rate was 85.6% at 42 months for those with type I, 88.4% at 42 months for those with type II, and 91.7% at 40 months for those with type III incontinence (P>0.05). The main postoperative complication was retention or difficulty in urination. It was concluded that the total suture length cannot be determined in relation to patient's physical parameters, but rather on surgical experience, and that this operation is recommended to those with not only intrinsic sphincter deficiency but also with urethral hypermobility, provided surgery is executed with safe precautions.
Kondo
A
A
Komaki Shimin Hospital, Japan.
Narushima
M
M
Itoh
Y
Y
Saito
M
M
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D009757:Nylons; D011183:Postoperative Complications; D013536:Suture Techniques; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016055:Urinary Retention; D016741:Urinary Sphincter, Artificial; D013519:Urogenital Surgical Procedures / Q000379:methods*; D014621:Vagina / Q000601:surgery*
D009757:Nylons