High rate of vaginal extrusion of silicone-coated polyester sling.
OBJECTIVE
To report the results of a pilot study evaluating the suitability of silicone-coated polyester as a suburethral sling material for female stress incontinence surgery.


METHODS
Ten women with stress or mixed urinary incontinence were prospectively evaluated with history and physical examination, pad test, urodynamic studies, and the Incontinence-Quality of Life questionnaire. The 2 x 7-cm sling was secured with transvaginal bone anchors placed through an anterior vaginal wall incision. Patients were evaluated at 1, 6, and 12 months by history and physical examination, pad test, and the Incontinence-Quality of Life and Success Rate and Overall Patient Satisfaction questionnaires.


RESULTS
Ten patients (mean age 62.3 years) underwent successful placement of the suburethral sling. The Incontinence-Quality of Life scores improved from a mean total score of 43.3 +/- 14.6 preoperatively to 97.7 +/- 14.4 at 1 year postoperatively (P <0.001). The Success Rate and Overall Patient Satisfaction questionnaires completed at 1 year demonstrated a mean satisfaction rating of 8.9 +/- 1.7 (scale 1 to 10), and the mean reported improvement in incontinence was 90% +/- 16.3%. The mean pad weight decreased from 103.1 +/- 33.2 g preoperatively to 1.6 +/- 1.01 g at 1 year (P <0.007). Two patients (20%) developed vaginal extrusion of the suburethral sling at 6 and 10 months. The slings were removed surgically. Both women healed without incident and reported continued continence at 1 year without additional surgical intervention.


CONCLUSIONS
Placement of a suburethral sling using transvaginal bone anchors and silicone-coated polyester is an effective surgical treatment for stress urinary incontinence at 1 year. The high rate of vaginal extrusion in our series limits its utility.
Comiter
Craig V
CV
Department of Surgery, Section of Urology, University of Arizona Health Science Center, Tucson, Arizona 85724, USA.
Colegrove
Peter M
PM
D020099:Coated Materials, Biocompatible / Q000009:adverse effects*; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology*; D006801:Humans; D008422:Materials Testing; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D011091:Polyesters; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000009:adverse effects*; D011788:Quality of Life; D012828:Silicones; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery; D014549:Urinary Incontinence / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures; D014621:Vagina
D020099:Coated Materials, Biocompatible; D011091:Polyesters; D012828:Silicones