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Accreditation of an old surgical technique for stress urinary incontinence: long-term outcomes of modified autologous fascial pubovaginal sling

  • Urology - Original Paper
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Abstract

Purpose

To evaluate long-term outcomes of modified autologous fascial pubovaginal sling (AFPVS) in women with stress urinary incontinence (SUI).

Methods

To evaluate long-term outcomes of modified AFPVS, we retrospectively reviewed the medical records of our patients from 2004 to 2015. From 2 decades ago, we have made modifications to classic surgical technique to make it simpler and faster.

Results

199 patients were contacted with mean age of 52 years. The mean follow-up period was 107 months. According to Revised Urinary Incontinence Scale (RUIS) questionnaire, overall success rate was 83.9%. In patients with positive history for SUI surgery, success rate was 73% compared to 87% in those without it. Body mass index was negatively associated with cure rate. We did not encounter any major complications and most of the issues were managed conservatively. Recurrence of SUI occurred in 6 patients (3.5%) after initial improvement.

Conclusion

Modified AFPVS is an effective surgical technique for treatment of SUI with high and durable success rate. At the present time with concerns regarding the use of transvaginal synthetic mesh, there is increasing interest and request for modified traditional procedures. It is likely that AFPVS may become more popular in upcoming years.

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References

  1. Agarwal BK, Agarwal N (2017) Urinary incontinence: prevalence, risk factors, impact on quality of life and treatment seeking behaviour among middle aged women. Int Surg J 4(6):1953–1958. https://doi.org/10.18203/2349-2902.isj20172131

    Article  Google Scholar 

  2. Capobianco G, Madonia M, Morelli S, Dessole F, Vita DD, Cherchi PL et al (2018) Management of female stress urinary incontinence: a care pathway and update. Maturitas 109:32–38. https://doi.org/10.1016/j.maturitas.2017.12.008

    Article  Google Scholar 

  3. McGuire EJ, Lytton B (1978) Pubovaginal sling procedure for stress incontinence. J Urol 119(1):82e4. https://doi.org/10.1016/S0022-5347(17)57390-5

    Article  Google Scholar 

  4. Gomes CM, Carvalho FL, Bellucci CH, Bellucci CHS, Hemerly TS, Baracat F et al (2017) Update on complications of synthetic suburethral slings. Int Braz J Urol 43(5):822–834. https://doi.org/10.1590/S1677-5538.IBJU.2016.0250

    Article  Google Scholar 

  5. Haylen BT, Sand PK, Swift SE, Maher C, Moran PA, Freeman RM (2012) Transvaginal placement of surgical mesh for pelvic organ prolapse: more FDA concerns – positive reactions are possible. Int Urogynecol J 23:11–13. https://doi.org/10.1007/s00192-011-1580-3

    Article  Google Scholar 

  6. Bailly GG, Carlson K (2017) The pubovaginal sling: reintroducing an old friend. Can Urol Assoc J 11:147–151. https://doi.org/10.5489/cuaj.4611

    Article  Google Scholar 

  7. Ghoniem GM, Rizk DEE (2018) Renaissance of the autologous pubovaginal sling. Int Urogynecol J 29(2):177–178. https://doi.org/10.1007/s00192-017-3521-2

    Article  Google Scholar 

  8. Rac G, Younger A, Clemens JQ, Kobashi K, Khan A, Nitti V et al (2017) Stress urinary incontinence surgery trends in academic female pelvic medicine and reconstructive surgery urology practice in the setting of the food and drug administration public health notifications. Neurourol Urodyn 36:1155–1160. https://doi.org/10.1002/nau.23080

    Article  CAS  Google Scholar 

  9. Sharma J, Thariani K, Deoghare M, Kumari R (2021) Autologous fascial slings for surgical management of stress urinary incontinence: a come back. J Obstet Gynaecol India 71(2):106–114. https://doi.org/10.1007/s13224-020-01408-3

    Article  CAS  Google Scholar 

  10. Sansoni J, Hawthorne G, Marosszeky N, Moore K, Fleming G, Owen E (2011) Validation and Clinical Translation of the Revised Continence and Patient Satisfaction Tools: Final Report. Centre for Health Service Development, University of Wollongong

  11. Athanasopoulos A, Gyftopoulos K, McGuire EJ (2011) Efficacy and preoperative prognostic factors of autologous fascia rectus sling for treatment of female stress urinary incontinence. Urology 78:1034–1038. https://doi.org/10.1016/j.urology.2011.05.069

    Article  Google Scholar 

  12. Lee D, Murray S, Bascu CD, Zimmern PE (2015) Long-term outcomes of autologous pubovaginal fascia slings: is there a difference between primary and secondary slings? Neurourol Urodyn 34:18–23. https://doi.org/10.1002/nau.22502

    Article  Google Scholar 

  13. Osman NI, Hillary CJ, Mangera A, Aldamanhoori R, Inman RD, Chapple CR (2018) The midurethral fascial “sling on a string”: an alternative to midurethral synthetic tapes in the era of mesh complications. Eur Urol 74(2):191–196. https://doi.org/10.1016/j.eururo.2018.04.031

    Article  Google Scholar 

  14. Chughtai BI, Elterman DS, Vertosick E, Maschino A, Eastham JA, Sandhu JS (2013) Midurethral sling is the dominant procedure for female stress urinary incontinence: analysis of case logs from certifying American Urologists. Urology 82:1267–1271. https://doi.org/10.1016/j.urology.2013.07.040

    Article  CAS  Google Scholar 

  15. Palmerola R, Peyronnet B, Rebolos M, Khan A, Sussman RD, Escobar C et al (2019) Trends in stress urinary incontinence surgery at a tertiary center: midurethral sling use following the AUGS/SUFU position statement. Urology 131:71–76. https://doi.org/10.1016/j.urology.2019.04.050

    Article  Google Scholar 

  16. Gomes CM, Carvalho FL, Bellucci CH, Hemerly TS, Baracat F, Bessa JD et al (2017) Update on complications of synthetic suburethral slings. Int Braz J Urol 43(5):822–834. https://doi.org/10.1590/S1677-5538.IBJU.2016.0250

    Article  Google Scholar 

  17. Kuuva N, Nilsson CG (2002) A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand 81:72–77. https://doi.org/10.1034/j.1600-0412.2002.810113.x

    Article  Google Scholar 

  18. Porena M, Costantini E, Frea B, Giannantoni A, Ranzoni S, Mearini L et al (2007) Tension-free vaginal tape versus transobturator tape as surgery for stress urinary incontinence: results of a multicentre randomised trial. Eur Urol 52:1481–1489. https://doi.org/10.1016/j.eururo.2007.04.059

    Article  Google Scholar 

  19. David-Montefiore E, Frobert JL, Grisard-Anaf M, Lienhart J, Bonnet K, Poncelet C et al (2006) Peri-operative complications and pain after the suburethral sling procedure for urinary stress incontinence: a French prospective randomised multicentre study comparing the retropubic and transobturator routes. Eur Urol 49:133–138. https://doi.org/10.1016/j.eururo.2005.09.019

    Article  Google Scholar 

  20. Kraus SR, Lemack GE, Richter HE, Brubaker L, Chai TC, Albo ME et al (2011) Changes in urodynamic measures two years after Burch colposuspension or autologous sling surgery. Urology 78:1263–1268. https://doi.org/10.1016/j.urology.2011.07.1411

    Article  Google Scholar 

  21. Kim A, Kim S, Kim HG (2020) Current overview of surgical options for female stress urinary incontinence. Int Neurourol J 24:222–230. https://doi.org/10.5213/inj.2040052.026

    Article  Google Scholar 

  22. Mahdy A, Ghoniem GM (2019) Autologous rectus fascia sling for treatment of stress urinary incontinence in women: a review of the literature. Neurourol Urodyn 38:51–58. https://doi.org/10.1002/nau.23878

    Article  Google Scholar 

  23. Sharifiaghdas F, Mahmoudnejad N, Honarkar Ramezani M, Shemshaki H, Ameri F (2019) Salvage autologous fascial sling after failed anti-incontinence surgeries: Long term follow up. Urol J 16(2):193–197. https://doi.org/10.22037/uj.v0i0.3934

    Article  Google Scholar 

  24. Petrou SP, Davidiuk AJ, Rawal B, Arnold M, Thiel DD (2016) Salvage autologous fascial sling after failed synthetic midurethral sling: greater than 3-year outcomes. Int J Urol 23:178–181. https://doi.org/10.1111/iju.13003

    Article  Google Scholar 

  25. Durante J, Manassero F, Fidecicchi T, Tognarelli A, Vico TD, Faviana P et al (2021) Autologous fascial slings remain viable at long-term follow-up: a post cystectomy case report. BMC Urol 21:122. https://doi.org/10.1186/s12894-021-00884-7

    Article  Google Scholar 

  26. Kim S, Wong DG, Lee D, Christie AL, Zimmern PE (2022) Very long-term follow-up of autologous pubovaginal fascia slings in women with stress urinary incontinence. Int Urogynecology J 33(4):821–828. https://doi.org/10.1007/s00192-021-04737-7

    Article  Google Scholar 

  27. Richter HE, Brubaker L, Stoddard AM, Xu Y, Zyczynski HM, Norton P et al (2012) Patient related factors associated with long-term urinary continence after Burch colposuspension and pubovaginal fascial sling surgeries. J Urol 188:485–489. https://doi.org/10.1016/j.juro.2012.04.010

    Article  Google Scholar 

  28. Brubaker L, Richter HE, Norton PA, Albo M, Zyczynski HM, Chai TC et al (2012) 5-year continence rates, satisfaction and adverse events of Burch urethropexy and fascial sling surgery for urinary incontinence. J Urol 187:1324–1330. https://doi.org/10.1016/j.juro.2011.11.087

    Article  CAS  Google Scholar 

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Funding

No funds, grants, or other support was received. The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Shahid Labbafi Nejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, 6517953371, Iran

    Farzaneh Sharifiaghdas, Nastaran Mahmoudnejad & Parham Montazeri

  2. Urology and Nephrology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

    Maede Mohseni

Authors
  1. Farzaneh Sharifiaghdas
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  2. Nastaran Mahmoudnejad
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  3. Maede Mohseni
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Correspondence to Maede Mohseni.

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Sharifiaghdas, F., Mahmoudnejad, N., Mohseni, M. et al. Accreditation of an old surgical technique for stress urinary incontinence: long-term outcomes of modified autologous fascial pubovaginal sling. Int Urol Nephrol 55, 277–283 (2023). https://doi.org/10.1007/s11255-022-03404-0

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  • DOI: https://doi.org/10.1007/s11255-022-03404-0

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