Vaginal Wall Sling for Female Stress Urinary Incontinence: Efficacy and Outcome Analysis

Jin, Yung Min; Kim, Young Il; Kim, Sang Kyu; Park, Nam Jong; Kim, Tae Kyu

Abstract

PURPOSE
The objective of this study was to assess the efficacy and clinical outcome of vaginal wall sling in the management of women with stress urinary incontinence.
MATERIALS AND METHODS
A total of 37 patients with stress urinary incontinence underwent vaginal wall sling procedure by a single surgeon from January 1998 to December 2001. All patients were evaluated preoperatively with detailed history, physical examination, urinalysis, abdominal ultrasonography, Q-tip test and stress provocation test. The 4 sutures comprising vaginal wall sling (two at the level of mid-urethral complex and two at the level of bladder neck) provide a rectangle of support and compression from the bladder neck to the mid-urethra. The efficacy and clinical outcomes of this procedure were evaluated.
RESULTS
With a mean follow-up of 19.2 months(5 to 46 months), 30 patients(81%) failed. Mean operation time was 63.3 minutes. Mean duration of indwelling catheter was 5.2 days and mean duration of hospitalization was 7.2 days. One patient(2.7%) suffered from prolonged voiding difficulty for 30 days. One patient(2.7%) had postoperative bleeding necessitating blood transfusion. De novo urge incontinence developed in 3 patients(8.1%). Other transient minor complications were urinary tract infection(13 cases), suprapubic discomfort(5 cases), and urgency(4 cases).
CONCLUSIONS
We consider that vaginal wall sling is a simple and effective procedure for the treatment of stress urinary incontinence, though longer follow-up is necessary to assess the long term effect.