Comparison of the outcomes of the sling technique using a commercial and hand-made polypropylene sling

PURPOSE: To compare the outcomes and costs of stress urinary incontinence (SUI) surgery using a hand-made sling (Marlex®) versus a commerciallyavailable suburethral polypropylene sling (Advantage®). MATERIALS AND METHODS: Thirty-nine women with SUI due to bladder neck hypermobility and/or sphincter incompetence diagnosed by clinical examination and urodynamic studies were divided into two groups: group 1 (n = 19) consisted of patients from an academic center (Department of Urology, University Hospital of Federal University of Maranhao, and group 2 (n = 20) patients from private practice. The hand-made polypropylene suburethral sling was used in group 1 and the commercial sling in group 2. The patients were evaluated 30, 60 and 90 days after surgery. RESULTS: The mean duration of surgery was 43 min. in group 1 and 51 min. in group 2. No postoperative voiding difficulties were observed in group 1 (100 percent), as well as, in 94.7 percent of patients of group 2. A bladder catheter was not required in any of the patients of the two groups at the end of the study. The level of satisfaction was 100 percent in group 1, whereas, one patient of group 2 considered the surgery to be unsuccessful. Urodynamic studies showed low amplitude uninhibited contraction in 11.1 percent of patients of group 1 and 10.5 percent of group 2. No complications were observed in either group. CONCLUSION: The hand-made polypropylene mesh (Marlex®) can be used for sling procedures, saving costs and yielding results similar to that obtained with commercial sling systems.

Fibrose do colo vesical tratada com ressecçäo endoscópica e aplicaçäo local de diacetato de triamcinolona / Vesical neck fibrosis treated with endoscopic resection and local application of triancinolone diacetate

Os autores mostram a experiência do Serviço de Urologia da 14ª Enfermaria da Santa Casa da Misericórida do Rio de Janeiro, com a utilizaçäo do diacetato de triamcinolona no tratamento da esclerose do colo vesical, com aplicaçäo local em 5 pacientes, obtendo-se resultados satisfatórios até a presente data