title: Surgical treatment for stress urinary incontinence with urethral hypermobility: what is the best approach?
abstract: A comparative study evaluating the results of three surgical procedures for stress urinary incontinence (SUI) with urethral hypermobility. This is a retrospective study of 189 patients, evaluating the outcomes of the percutaneous needle suspension using bone anchors (PNS), abdominal suspension (AS), and pubovaginal sling (PVS). The mean follow-up was 30.5 months. In our results, the patients were divided into three groups: PNS (49), AS (34), and PVS (106). No differences were found preoperatively. Intraoperatively, PNS had the shortest operative time and lowest estimated blood loss, and it is the only outpatient procedure. However, it had the highest complication rate. PNS had the lowest satisfactory rate (16.7%). This was followed by AS (78%), PVS with cadaveric fascia (90%), and PVS with autologous fascia (94%). In conclusion, PNS is a simple outpatient procedure, but the long-term results are disappointing. Both AS and PVS gave good results. PVS was superior to AS in shorter hospitalization, early recovery and overall patient satisfaction.
authors.affiliation: Department of Urology, Kaiser Permanente Medical Center, 4900 Sunset Boulevard, 2nd Floor, Los Angeles, CA 90027, USA.
authors.forename: G W
authors.initials: GW
authors.lastname: Chien
authors.forename: M
authors.initials: M
authors.lastname: Tawadroas
authors.forename: J S
authors.initials: JS
authors.lastname: Kaptein
authors.forename: M S
authors.initials: MS
authors.lastname: Mourad
authors.forename: N
authors.initials: N
authors.lastname: Tebyani
authors.forename: S R
authors.initials: SR
authors.lastname: Aboseif
mesh_terms: D000005:Abdomen / Q000601:surgery*; D001858:Bone Nails / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D009339:Needles / Q000009:adverse effects*; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014522:Urethral Diseases / Q000150:complications* / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000150:complications* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects*; D014621:Vagina / Q000601:surgery*