title: Preventing urethral obstruction using the 6-point fixation and weight-adjusted spacing nomogram during sling surgery.
abstract: The aim of the study was to assess the outcome of a 6-point fixation technique and weight-adjusted spacing nomogram for performing sling surgery. Fifty women with stress incontinence underwent implantation of a Gore-tex patch sling. Sling tension was gauged based on the patient's body weight. Postoperative analysis was performed using cough stress tests, Q-tip tests, pelvic examinations and patient satisfaction questionnaires. Urodynamics were performed for women with persistent incontinence. Mean follow-up was 24 months (range 7-28). Mean age was 58 years (range 29-87). Stress incontinence was cured in 47/50 patients (94.0%). De novo urge incontinence occurred in 1/23 (4.3%) patients. Mean time to suprapubic tube removal was 7 days (range 1-21). No patients experienced urinary retention or urethral obstruction. Mean satisfaction score was 9/10 (range 7-10) and all patients said they would undergo surgery again. The combination of a 6-point fixation technique and a weight-adjusted spacing nomogram allows for a successful sling outcome without obstruction.
authors.affiliation: Urodynamics and Continence Center, University of Cincinnati, Ohio 45267, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Choe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001835:Body Weight; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D013526:Surgical Mesh; D014524:Urethral Obstruction / Q000209:etiology / Q000517:prevention & control*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods*