Long Term Results of Pubovaginal Sling Procedure Based on Anchoring Sites of Suture Material

Paik, Kyeong Seok; Kim, Dae Woo; Park, Seok San

Abstract

PURPOSE: The long term results of a pubovaginal sling procedure were assessed in females with stress urinary incontinence (SUI), and the safety and efficacy, between the Cooper's ligament anchoring and the abdominal wall anchoring of the suture material, compared.
MATERIALS AND METHODS
Fifteen, and 20, women underwent a pubovaginal sling procedure, with abdominal wall anchoring (group I), or with Cooper's ligament anchoring (group II), respectively. The surgical outcomes, the satisfaction of patients and the complications were assessed by a questionnaire.
RESULTS
In groups I and II the mean follow-ups were 58.1 (range 43-71) and 42.5 (range 36-50) months, respectively. Thirteen (86.6%) and 1 (6.7%), and 17 (85.0%) and 2 (10.0%) of the patients in groups I, and II, were cured and improved, respectively. No statistical difference in the self-reported satisfaction scores was shown between the two groups. The duration of the hospital stay and residual urine less than 50ml were significantly lower in group II (p<0.01). No permanent urinary retention or de novo urge incontinence occurred, but the postoperative urgency remained at 50.0% in both groups.
CONCLUSIONS
According to our long term follow-up, the pubovaginal sling procedure is a highly effective and safe surgery for SUI, without urge incontinence. The modified technique, of a pubovaginal sling procedure, with anchoring of the fascia at the Cooper's ligament, is an alternative treatment for SUI, with a low complication rate.