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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. © The International Urogynecological Association 2013.