Success of pubovaginal sling in patients with stress urinary incontinence and efficacy of vaginal sling release in patients with post-sling voiding dysfunction.
OBJECTIVE
To assess the overall success of sling procedures and surgical sling release in achieving urinary continence and voiding function in women with stress urinary incontinence.


METHODS
We reviewed the charts of 107 patients with stress urinary incontinence who had a two-team abdominal-vaginal fascial sling procedure performed between January 2000 and December 2003. Data reviewed included the patients' medical history, demographic data, findings on physical examination, urodynamic studies, operative report, and findings at visits 6 weeks, 6 months, and 12 months after surgery. Patients with sling releases were followed up to assess pelvic organ prolapse, uroflowmetry, and post-void residual urine volume, and to complete the quality of life questionnaire IIQ-7.


RESULTS
At one year after pubovaginal sling surgery, 82.1% of patients were cured of stress urinary incontinence. The majority (85.1%) of patients did not develop postoperative voiding dysfunction. Only 5.6% of those who did develop postoperative voiding dysfunction required surgical sling release. Sling release resolved the post-sling voiding dysfunction in three out of five patients.


CONCLUSIONS
Pubovaginal sling surgery is a highly successful strategy for the management of stress urinary incontinence and has a low rate of postoperative voiding dysfunction. Surgical sling release may resolve post-sling voiding dysfunction.
Kwon
Elena
E
Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB.
Schulz
Jane A
JA
Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB.
Flood
Cathy G
CG
Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB.
D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D014524:Urethral Obstruction / Q000453:epidemiology; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*