Pubovaginal sling for the treatment of female stress urinary incontinence: experience of 100 cases at Ramathibodi Hospital.

OBJECTIVE

To evaluate the outcome of pubovaginal sling procedure for treatment of female stress urinary incontinence.

MATERIAL AND METHOD: From September 1997 to January 2000, one hundred consecutive patients with urodynamically proven stress incontinence had a pubovaginal sling procedure performed. Operative technique, intraoperative and post-operative complications, voiding patterns, residual urine as well as the follow-up course were reviewed.

RESULTS

Of one hundred cases, the mean patient age was 52.6 years old (range 34-73). The etiologies of stress incontinence were 85 cases of urethral hypermobility and 15 cases of intrinsic sphincter deficiency (ISD). Eighteen cases were after failure of prior continence procedures. No intraoperative and post-operative complications were found except one case of wound infection. Minimal bleeding was noted. Marked post-operative residual urine (>100 ml) was found in 39 cases and clean intermittent catheterization was used. The mean time for catheterization was 8.9 weeks (range 2-12 weeks). The mean time to follow-up was 12.1 months (range 4-36 months). Ninety-four cases had been completely dried in the follow-up period since the last visit and 5 cases had much improvement of incontinence using only 1-2 pads/day. Only one case was found to have failed the procedure. De novo instability was found in 5 cases.

CONCLUSION

On the basis of these results, we propose that pubovaginal sling is an effective treatment for female stress incontinence with very few complications.