Pubovaginal sling with a low-cost polypropylene mesh.
OBJECTIVE
The aim of this study was to present the results of pubovaginal sling with a low-cost polypropylene mesh in the treatment of stress urinary incontinence.


METHODS
118 women diagnosed with stress urinary incontinence (SUI) due to urethral hypermobility or intrinsic sphincteric deficiency, treated with pubovaginal sling (PVS) with a low-cost polypropylene mesh confectioned by the surgeon, were analyzed. All patients had a basic evaluation that included a medical history, physical examination, stress tests and urodynamic investigation.


RESULTS
The average follow up was of 42 months. Urethral hypermobility was observed in 67% of the cases. The process was carried out on an outpatient basis on 67 patients. Intra-operative complications included 4 vesical injuries, treated with catheterization for 3 days. There were 13 early complications, of which 8 were urinary retentions treated with vesical drainage for 1 to 3 weeks and 3 vaginal extrusions of the mesh treated with covering of the sections with mucous membrane. There was a need for 6 urethrolysis in patients who presented irritative and postoperative obstructive symptoms; 81.3% of the patients were considered cured, while 9.3% had significant improvement. Three initially unsuccessful cases required sling reconfiguration. All cases were eventually cured.


CONCLUSIONS
The construction of a pubovaginal sling using a low-cost polypropylene mesh is a safe and effective technique for the relief of SUI. It should be considered an alternative, especially for patients in public health systems with low financial resources.
Rodrigues
Fransber R
FR
Service of Urology, Brasilia University Hospital, Brasilia, DF, Brazil. fransber.rodrigues@sbu.org.br
Maroccolo Filho
Romulo
R
Maroccolo
Roberto R
RR
Paiva
Lucio C
LC
Diaz
Fernando A
FA
Ribeiro
Eduardo C
EC
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011126:Polypropylenes / Q000191:economics / Q000627:therapeutic use*; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000191:economics*; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics
D011126:Polypropylenes