Pubovaginal Sling Using Mesh and Fixed to Cooper's Ligament: Comparison of Efficacy with Anterior Vaginal Wall Sling

Cho, Yong Jun; Park, Hae Young; Lee, Tchun Yong

Abstract

PURPOSE: The results of pubovaginal sling operation using mersilene mesh fixed to Cooper's ligament(Cooper's ligament sling;CLS) were evaluated and compared with the results of anterior vaginal wall sling(AVWS).
MATERIALS AND METHODS
One hundred forty patients who had undergone sling operation and had been followed up for more than one year were enrolled in the study. Sixty patients underwent CLS and 80 AVWS. Therapeutic efficacy and complications were evaluated by reviewing medical records and by telephone interview.
RESULTS
Mean operating times were 93 and 87 minutes, mean urethral Foley catheter indwelling times were 1.5 and 1.8 days and mean postoperative hospital stays were 5.1 and 5.2 days, respectively, in the CLS and AVWS groups(p>0.05). Recurrence of incontinence was reported by 6 patients in the CLS group and 7 in the AVWS group(p>005). The incidence of significant complication and postoperative urge incontinence did not show a statistically significant difference between the two groups. Suprapubic pain of more than 1-month duration after surgery was found in patients in the AVWS group only, which had disappeared at 6 months after operation. The postoperative satisfaction state was statistically similar in both groups.
CONCLUSIONS
Pubovaginal sling operation using mersilene mesh fixed to Cooper's ligament compares favorably with AVWS in terms of incontinence rate and complication. It has the clear advantages of being relatively cheap and devoid of the transvesical suprapubic pain that is seen with AVWS, and, furthermore, has the theoretical advantage of increased durability due to fixation to a fixed portion. Follow up for a longer period of time should be done.