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An inelastic retropubic suburethral sling in women with intrinsic sphincter deficiency

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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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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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Authors and Affiliations

  1. Department of Gynecology, Urogynecology & Reconstructive Pelvic Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA

    Alfredo Jijon, Aparna Hegde, Beatriz Arias, Vivian Aguilar & G. Willy Davila

Authors
  1. Alfredo Jijon
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  2. Aparna Hegde
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  3. Beatriz Arias
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  4. Vivian Aguilar
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  5. G. Willy Davila
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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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  • DOI: https://doi.org/10.1007/s00192-012-2007-5

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