Pubovaginal Sling for the Treatment of Female Stress Urinary Incontinence: Experience of 100 Cases at Ramathibodi Hospital
WACHIRA KOCHAKARN, M.D.*, CHAROEN LEENANUPUNTH, M.D.*, KRISADA RATANA-OLARN, M.D.*, UBOLRAT ROONGREUNGSILP, B.Sc. (Nursing), M.Sc.**, NICHA SIRIPORNPINYO, B.Sc. (Nursing)**
Affiliation : *Division of Urology, Department of Surgery, ** Department of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Objective : To evaluate the outcome of pubovaginal sling procedure for treatment of female stress urinary incontinence.
Materials and Methods : From September 1997 to January 2000, one hundred consecutive patients with urodynamically proven stress incontinence had a pubovagina1 sling procedure per- formed. 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 proce- dures. 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 effec- tive treatment for female stress incontinence with very few complications.
Keywords : Pubovaginal Sling, Stress Urinary Incontinence, Surgery
