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Original ArticleOpen Access
A Randomized Controlled Trial of Pubovaginal Sling versus Vaginal Wall Sling for Stress Urinary Incontinence
Viseshsindh W 
,
Kochakarn W ,
Waikakul W ,
Roongruangsilp U ,
Siripornpinyo N ,
Viseshsindh V
,
Kochakarn W ,
Waikakul W ,
Roongruangsilp U ,
Siripornpinyo N ,
Viseshsindh V Purpose : To compare the results of Pubovaginal sling and Vaginal wall sling for the treatment
of stress urinary incontinence in females.
Material and Method : Between February 2001 and December 2001, a randomized controlled
trial was done to compare safety and efficacy of pubovaginal sling versus vaginal wall sling in the
management of women with urinary incontinence. Fifteen women 42-68 years old (mean age 51.3
years) were treated with fascial sling (group A) and 11 women 45-60 years old (mean age 50.4 years)
with vaginal wall sling (group B). Twenty-one patients had type II SUI and 5 patients had type III SUI
(ISO); none had pre-operative detrusor instability. Measures of outcome included efficacy based on
SEAPI-QMN, post-operative presence of stress or urge incontinence, frequency of complications,
operative time, post-operative pain, length of hospitalization, length of clean intermittent catheterization
(CIC) time and mean global evaluation.
Results : All patients were followed for at least 3 months after surgery (median 7 months). A
total of 20 and 6 women received spinal and general anesthesia, respectively. SEAPI-QMN decreased
from a median of 6.3 to 0.8 for group A and from 6.1 to 0.9 for group B. No patient in either group had
persistent stress incontinence. Urge incontinence was present in 2 of group A patients and 1 of group B
patients. No serious post-operative complications were encountered in both groups. Post-operative pain
and operative times for group B patients were significantly lower than for group A patients. Length of
hospitalization, length of CIC time and mean global evaluation were not significantly different between
the two groups.
Conclusion : In the short-term, both pubovaginal sling and vaginal wall slings were effective
in the treatment of women with SUI. However, the use of vaginal wall sling resulted in significantly
shorter operative times and lower post-operative pain compared with pubovaginal sling. Therefore, the
vaginal wall sling should be the prefered treatment for SUI.
Key word : Stress Urinary Incontinence, Surgery, Pubovaginal Sling, Vaginal Wall Sling, Randomized Controlled Trial
of stress urinary incontinence in females.
Material and Method : Between February 2001 and December 2001, a randomized controlled
trial was done to compare safety and efficacy of pubovaginal sling versus vaginal wall sling in the
management of women with urinary incontinence. Fifteen women 42-68 years old (mean age 51.3
years) were treated with fascial sling (group A) and 11 women 45-60 years old (mean age 50.4 years)
with vaginal wall sling (group B). Twenty-one patients had type II SUI and 5 patients had type III SUI
(ISO); none had pre-operative detrusor instability. Measures of outcome included efficacy based on
SEAPI-QMN, post-operative presence of stress or urge incontinence, frequency of complications,
operative time, post-operative pain, length of hospitalization, length of clean intermittent catheterization
(CIC) time and mean global evaluation.
Results : All patients were followed for at least 3 months after surgery (median 7 months). A
total of 20 and 6 women received spinal and general anesthesia, respectively. SEAPI-QMN decreased
from a median of 6.3 to 0.8 for group A and from 6.1 to 0.9 for group B. No patient in either group had
persistent stress incontinence. Urge incontinence was present in 2 of group A patients and 1 of group B
patients. No serious post-operative complications were encountered in both groups. Post-operative pain
and operative times for group B patients were significantly lower than for group A patients. Length of
hospitalization, length of CIC time and mean global evaluation were not significantly different between
the two groups.
Conclusion : In the short-term, both pubovaginal sling and vaginal wall slings were effective
in the treatment of women with SUI. However, the use of vaginal wall sling resulted in significantly
shorter operative times and lower post-operative pain compared with pubovaginal sling. Therefore, the
vaginal wall sling should be the prefered treatment for SUI.
Key word : Stress Urinary Incontinence, Surgery, Pubovaginal Sling, Vaginal Wall Sling, Randomized Controlled Trial
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