The Effectiveness and Satisfaction of Modified Fascial Sling in Patients with Stress Urinary Incontinence: Comparison between Simple and Complex Types

Park, Yong Ju; Yoon, Sang Jin; Lee, Jong Bouk

Abstract

PURPOSE: Sling operation is applied to all types of the stress urinary incontinence (SUI) nowadays. We evaluated and compared the operation success rate and patient satisfaction between simple and complex types of SUI for patients who had undergone the modified fascial sling.
MATERIALS AND METHODS
We reviewed 147 patients who were treated with the modified fascial sling for SUI. Patients were categorized into simple and complex types according to the classification of Chaikin et al. Surgical outcome and patient satisfaction were assessed by questionnaire.
RESULTS
Of the 147 patients, 62 were simple type (42%) and 85 complex type (57%). In complex type, there were 76 cases of urge incontinence (89%), and 16 of grade 3 or 4 cystocele (19%). Mean duration of follow-up was 39.5 months (range 12-64). For operation outcome results, in simple type there were 56 cases of cure (90%) and 4 of improvement (6%), and in complex type there were 76 cases of cure (90%) and 6 of improvement (7%). The operation satisfaction rate of patients was 94% in simple type and 86% in complex type. Persistent urge incontinence was seen in 15 cases (20%) of 76 patients with preoperative urge incontinence. Complications were de novo urge incontinence in 5 cases (3%) and urinary retention in 7 cases (5%) of the sling operation.
CONCLUSIONS
This study shows that the success rate of modified fascial sling in both simple and complex types of SUI was represented by the high result of 97%. However, the satisfaction rate for the surgery was somewhat different between the 2 types (94% vs. 86%). The main reason for the dissatisfaction was persistent urge incontinence.