Therapeutic Effectiveness of In Situ Anterior Vaginal Wall Sling in Patients with Stress Urinary Incontinence

Lee, Joo Hwan; Kwon, Tae Gyun; Park, Yoon Kyu

Abstract

PURPOSE: To determine the efficacy and safety of the in situ anterior vaginal wall sling procedure for the treatment of anatomical incontinence (AI) and intrinsic sphincter dysfunction (ISD).
MATERIALS AND METHODS
A total of 53 women (31 with AI and 22 with ISD), having undergone in situ anterior vaginal wall sling procedures, were reviewed. The preoperative evaluation included a detailed history taking, physical examination and urodynamic study, including Valsalva leak point pressure (VLPP) and incontinence staging, with Stamey grade. The efficacy and clinical outcome of this procedure were accessed by telephone interviews.
RESULTS
With a mean follow up of 30.8 months (24-52), 49 (92.5%) of the 53 patients were completely continent or improved. The success rate of AI and ISD patients were 93.5 and 90.9% respectively. One patient (1.9%) required a prolonged Foley catheter drainage of up to 2 weeks. Sixteen (84.2%) out of the 19 patients with preoperative urge incontinence improved postoperatively, and de novo urge incontinence developed in 1 patient (1.9%). Postoperative wound infections developed in 3 patients (5.7%).
CONCLUSIONS
The in situ anterior vaginal wall sling procedure can be an effective and safe surgical treatment option in both AI and ISD patients.