Abstract
Objectives
To report the results of a pilot study evaluating the suitability of silicone-coated
polyester as a suburethral sling material for female stress incontinence surgery.
Methods
Ten women with stress or mixed urinary incontinence were prospectively evaluated with
history and physical examination, pad test, urodynamic studies, and the Incontinence-Quality
of Life questionnaire. The 2 × 7-cm sling was secured with transvaginal bone anchors
placed through an anterior vaginal wall incision. Patients were evaluated at 1, 6,
and 12 months by history and physical examination, pad test, and the Incontinence-Quality
of Life and Success Rate and Overall Patient Satisfaction questionnaires.
Results
Ten patients (mean age 62.3 years) underwent successful placement of the suburethral
sling. The Incontinence-Quality of Life scores improved from a mean total score of
43.3 ± 14.6 preoperatively to 97.7 ± 14.4 at 1 year postoperatively (P <0.001). The Success Rate and Overall Patient Satisfaction questionnaires completed
at 1 year demonstrated a mean satisfaction rating of 8.9 ± 1.7 (scale 1 to 10), and
the mean reported improvement in incontinence was 90% ± 16.3%. The mean pad weight
decreased from 103.1 ± 33.2 g preoperatively to 1.6 ± 1.01 g at 1 year (P <0.007). Two patients (20%) developed vaginal extrusion of the suburethral sling
at 6 and 10 months. The slings were removed surgically. Both women healed without
incident and reported continued continence at 1 year without additional surgical intervention.
Conclusions
Placement of a suburethral sling using transvaginal bone anchors and silicone-coated
polyester is an effective surgical treatment for stress urinary incontinence at 1
year. The high rate of vaginal extrusion in our series limits its utility.
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Article info
Publication history
Accepted:
January 30,
2004
Received:
November 21,
2003
Footnotes
☆This study was supported in part by American Medical Systems.
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
