Results of Long-term Follow-up for the Pubovaginal Fascial Sling Procedure in the Treatment of Female Stress Urinary Incontinence

Roh, An Sik; Na, Yong Gil; Sul, Chong Koo

Abstract

PURPOSE
We report results of long-term follow-up (more than 2 years) for the pubovaginal fascial sling procedure in the treatment of female stress urinary incontinence (SUI).
MATERIALS AND METHODS
A retrospective analysis of 51 women with SUI, consecutively having undergone a pubovaginal fascial sling procedure, was undertaken. Patients were evaluated preoperatively, by physical examination, voiding cystourethrography, Q-tip test, and urodynamic study including; valsalva leak point pressure (VLPP), and their incontinence ranked according to the Stamey grades. Of the 51 patients, 19 cases (37%) were anatomically incontinent, 24 cases (47%) were intrinsically sphincter deficient (ISD) and 8 cases (16%) were of the equivocal type, according to VLPP. The patients were assessed by questionnaire and SEAPI (stress-related leakage, emptying ability, anatomy, protection, inhibition) scores, postoperatively.
RESULTS
The pubovaginal fascial sling procedure was effective in 96.1% (cured 84.3%, improved 11.8%) of SUIs, with more than 2 years follow up (mean follow up 34.1 months; 24 to 49 months). There was no significant relationship between VLPP and success rate, and no significant changes in the postoperative outcome over time. The main complications were de novo urge incontinence (3 cases; 5.8%) and permanent urinary retention (3 cases; 5.8%), with transvaginal urethrolysis being performed in the latter cases.
CONCLUSIONS
We would conclude that the pubovaginal fascial sling procedure is an effective treatment modality for the female SUI.