title: An inelastic retropubic suburethral sling in women with intrinsic sphincter deficiency.
abstract: OBJECTIVE
  We evaluated outcomes of an inelastic retropubic sling in patients with intrinsic sphincteric deficiency (ISD).
  
  
  METHODS
  This is a retrospective review of women diagnosed with ISD according to urodynamic parameters who underwent a retropubic suburethral sling surgery using a tape with minimal elasticity. All patients in the study where followed up at 2, 6, and 24 weeks and yearly. Outcome measures included self-assessed satisfaction, daily incontinence episodes and pad usage, standardized stress test, postvoid residual volume, and surgical complications.
  
  
  RESULTS
  Two hundred and forty-seven patients were involved in this study, with a median follow-up of 43 [interquartile range (IQR) 22-77] weeks and a minimum of 12 weeks. Two patients (0.008 %) had a positive stress test postoperatively. There was a decrease in daily incontinence events (median 1.5-0) (p < 0.001) and pad usage per day (median 1.5-0) (p < 0.001). Two hundred and sixteen (87.4 %) patients reported subjective improvement in symptoms. Urinary retention was found in 18 (7.2 %) patients, and 19 (7.7 %) patients required reintervention, mostly with bulking agent injections for persistent incontinence. No tape-related mesh exposures were reported.
  
  
  CONCLUSIONS
  Retropubic suburethral inelastic slings represent a good option for treating patients with ISD, with satisfactory continent rates and low postoperative complications.
authors.affiliation: Department of Gynecology, Urogynecology & Reconstructive Pelvic Surgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Jijon
authors.forename: Aparna
authors.initials: A
authors.lastname: Hegde
authors.forename: Beatriz
authors.initials: B
authors.lastname: Arias
authors.forename: Vivian
authors.initials: V
authors.lastname: Aguilar
authors.forename: G Willy
authors.initials: GW
authors.lastname: Davila
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004548:Elasticity; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012008:Recurrence; D012189:Retrospective Studies; D053825:Suburethral Slings; D016896:Treatment Outcome; D014521:Urethra / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D016055:Urinary Retention / Q000453:epidemiology; D014563:Urodynamics / Q000502:physiology