The surgical results of the pubovaginal sling procedure using polypropylene mesh for stress urinary incontinence.
OBJECTIVE
To investigate the surgical results after a pubovaginal sling procedure using polypropylene mesh in women with stress urinary incontinence (SUI).


METHODS
Sixty-four women with different types of SUI underwent a pubovaginal sling procedure, using polypropylene mesh. The sling was placed at the level of the proximal half of the urethra and tied with adequate tension, but not obstructing the bladder outlet. A video-urodynamic study and transrectal ultrasonography were undertaken before and after surgery. The surgical results were assessed and the urodynamic changes compared at different stages.


RESULTS
At a median follow-up of 24 months, 52 patients (81%) were completely continent, 10 (16%) had an improvement but with mild SUI, and two had persistent SUI requiring a second sling procedure. The treatment result was considered satisfactory by 55 patients (86%). The video-urodynamic study showed no significant change in voiding pressure, cystometric capacity and residual urine volume after surgery. The bladder neck opening time was increased at 7 days and the maximum flow rate increased at 3 months after surgery. Transrectal ultrasonography showed that all the polypropylene mesh slings were located beneath the bladder neck and proximal urethra, with no notable granuloma formation around the sling.


CONCLUSIONS
The pubovaginal sling procedure is effective in treating female SUI, using polypropylene mesh as the sling material. The video-urodynamic results showed that a pubovaginal sling of polypropylene mesh causes no bladder outlet obstruction when the correct surgical technique is used.
Kuo
H C
HC
Department of Urology, Buddhist Tzu Chi College of Medicine and General Hospital, Hualien, Taiwan. hck@tzuchi.com.tw
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011126:Polypropylenes / Q000627:therapeutic use*; D013526:Surgical Mesh; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D014621:Vagina / Q000601:surgery*; D014741:Video Recording; D014743:Videotape Recording
D011126:Polypropylenes