Five Year Follow-up Results of the Pubovaginal Fascial Sling Surgery in the Female Stress Urinary Incontinence / 대한비뇨기과학회지

ABSTRACT

PURPOSE: The long term results of pubovaginal fascial sling surgery were evaluated in female stress urinary incontinence (SUI), and were compared with concomitant surgery in pelvic organ prolapse. MATERIALS AND METHODS: A total of 47 SUI patients were treated with pubovaginal fascial sling surgery between 1997 and 2000. A satisfaction evaluation and success grading of the operation were studied. A postoperative evaluation was performed via a survey questionnaire, uroflowmetry and post-void residuals. RESULTS: Forty-five patients (95.7%) showed successful results at the 2- & 5-year follow-ups, but 2 patients (4.3%) failed. There were no significant differences in success rates according to Valsalva leak point pressure (VLPP) and the pelvic organ prolapse surgery. Thirty-one patients (66.0%) were satisfied with their result, while 16 (34.0%) were unsatisfied at the 2-year follow up. Those unsatisfied with the result included 8 with a urethral obstruction, 6 with urge incontinence and 2 with persistent SUI. Two patients with prolonged urinary retention had undergone urethrolysis. Postoperative de novo and persistent urge incontinence occurred in 2 and 4 patients, respectively. Two patients with persistent SUI were cured using the midurethral sling. Finally, forty-one patients (87.2%) were satisfied with the results, while 6 (12.8%) were unsatisfied at the 5-year follow-up. CONCLISIONS The 5-year follow-up results of the pubovaginal fascial sling surgery showed a high success rate and relatively good results with respect to satisfaction with the procedure. If a urethral obstruction and urge incontinence are treated carefully, sling surgery can be considered as an efficient method for any type of urinary incontinence.