Short-term complications of pubovaginal sling procedure for genuine stress incontinence in women.

OBJECTIVES

To evaluate the complication rate intraoperatively and within the first 30 postoperative days of the pubovaginal sling procedure.

METHODS

From January 1992 to September 1996, we prospectively analyzed 90 women with type II and III genuine stress incontinence (age 38 to 84 years, average Valsalva leak point pressure 57.5 cm H2O) who underwent the pubovaginal sling procedure at our institute. Sixty percent of patients had no previous surgical treatment for their incontinence. Thirty-three percent of our patients have significant comorbidity (chronic obstructive lung disease, diabetes, coronary artery disease, peripheral vascular disease).

RESULTS

The complication rate within the first 30 postoperative days was 19%, which included pneumonia (1.1%), deep venous thrombosis (1.1%), urinary retention (3.3%), wound infection (7.7%), intraoperative bladder laceration (3.3%), urinary tract infection (1.1%), and superficial thrombophlebitis (1.1%). A similar complication rate was noted among our patients with no previous surgical treatment for their incontinence.

CONCLUSIONS

The complication rate of our prospective series of pubovaginal sling procedures was comparable to that of the other surgical procedures for genuine stress incontinence reported in the literature. We conclude that even though the pubovaginal sling procedure is a relatively complex surgery, in view of its satisfactory long-term success rate reported in the recent literature, pubovaginal sling procedure should also be considered a primary surgical treatment for genuine stress incontinence in a selected population of women.