An inelastic retropubic suburethral sling in women with intrinsic sphincter deficiency

Abstract

Introduction and hypothesis

We evaluated outcomes of an inelastic retropubic sling in patients with intrinsic sphincteric deficiency (ISD).

Methods

This is a retrospective review of women diagnosed with ISD according to urodynamic parameters who underwent a retropubic suburethral sling surgery using a tape with minimal elasticity. All patients in the study where followed up at 2, 6, and 24 weeks and yearly. Outcome measures included self-assessed satisfaction, daily incontinence episodes and pad usage, standardized stress test, postvoid residual volume, and surgical complications.

Results

Two hundred and forty-seven patients were involved in this study, with a median follow-up of 43 [interquartile range (IQR) 22–77] weeks and a minimum of 12 weeks. Two patients (0.008 %) had a positive stress test postoperatively. There was a decrease in daily incontinence events (median 1.5–0) (p < 0.001) and pad usage per day (median 1.5–0) (p < 0.001). Two hundred and sixteen (87.4 %) patients reported subjective improvement in symptoms. Urinary retention was found in 18 (7.2 %) patients, and 19 (7.7 %) patients required reintervention, mostly with bulking agent injections for persistent incontinence. No tape-related mesh exposures were reported.

Conclusion

Retropubic suburethral inelastic slings represent a good option for treating patients with ISD, with satisfactory continent rates and low postoperative complications.

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Fig. 1

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Conflicts of interest

GW Davila: honoraria, American Medical Systems, CL Medical, Astellas, Warner-Chilcott; consultant, American Medical Systems, Coloplast, CL Medical, Astellas; research funding, CL Medical. Other authors: No conflict of interest

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Correspondence to G. Willy Davila.

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Jijon, A., Hegde, A., Arias, B. et al. An inelastic retropubic suburethral sling in women with intrinsic sphincter deficiency. Int Urogynecol J 24, 1325–1330 (2013). https://doi.org/10.1007/s00192-012-2007-5

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Keywords

  • Intrinsic sphincteric deficiency
  • Stress urinary incontinence
  • I-STOP sling