title: Long-term efficacy of the pubovaginal Mersilene mesh sling.
abstract: The objective of the study was to determine the efficacy of the pubovaginal Mersilene mesh sling (PVMMS) for complicated urodynamic stress incontinence (USI).
  
  
  
  Between 1990 and 2008, patients with USI plus an at-risk diagnosis underwent a PVMMS by a single surgeon. They were followed up with urodynamics (UDE) and Pelvic Floor Distress Inventory-short form 20 (PFDI-20). Stratification was in an at-risk hierarchy: intrinsic sphincter deficiency (ISD) greater than recurrent USI (RUSI) greater than USI with chronically increased intraabdominal pressure (CI-IAP). A cough stress test determined objective cure. PFDI question 17 assessed subjective cure.
  
  
  
  Three hundred six patients with ISD (43.5%), RUSI (26.8%), and CI-IAP (29.7%) had objective cure rates of 89.2% in the short term, 86.7% in the intermediate term, and 91.2% in the long term. A group of 48 patients with both short- and long-term UDEs showed cures of 100% and 91.7%. Long-term objective cure rates were: ISD, 90.5% (n = 21); RUSI, 84.2%, (n = 19); CI-IAP, 100% (n = 17). The mean score of postoperative PFDI question 17 was 0.57 (n = 119). Mean symptom improvement was -2.98 (n = 52; P < .0001).
  
  
  
  We demonstrated PVMMS to be subjectively and objectively effective in long-term treatment of complicated forms of USI.
authors.affiliation: Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, USA. youngS01@ummhc.org
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Young
authors.forename: Allison E
authors.initials: AE
authors.lastname: Howard
authors.forename: Diego S
authors.initials: DS
authors.lastname: Illanes
authors.forename: Emily E
authors.initials: EE
authors.lastname: Weber LeBrun
authors.forename: Janet R
authors.initials: JR
authors.lastname: Hardy
authors.forename: Scott M
authors.initials: SM
authors.lastname: Kambiss
authors.forename: Katharine K
authors.initials: KK
authors.lastname: O'Dell
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011446:Prospective Studies; D053825:Suburethral Slings; D013526:Surgical Mesh; D014550:Urinary Incontinence, Stress / Q000601:surgery*
chemical_list: D011093:Polyethylene Terephthalates; C025539:Lavsan