Pubovaginal Sling Operation Using Cadaveric Fascia Lata for the Female Stress Urinary Incontinence

ABSTRACT

PURPOSE: Pubovaginal sling operation has been main treatment procedure for female stress urinary incontinence. Allografts have been substituted for autografts as the material of pubovaginal sling operation to decrease postoperative morbidity, although to our knowledge their long-term durability is unknown. Therefore, we investigated the outcome and efficacy of pubovaginal sling operation using allograft cacaveric fascia lata. MATERIALS AND METHODS: From September 2000 to December 2001, 47 patients with stress urinary incontinence underwent pubovaginal sling operation using cadaveric fascia lata and had been followed up more than 10 months. Preoperative evaluation included medical history, physical examination, SEAPI score and urodynamic study including Abdominal leak point pressure (ALPP). All patients were assessed for the outcome of the procedure with subjective satisfaction by scores of SEAPI classification. RESULTS: With a mean follow-up of 18.2 months(range 10 to 25), urinary incontinence completely disappeared in 42 patients(89.4%), significantly improved in 4 patients(8.5%), not improve in 1 patient(2.1%). Marked improvement was shown in all patients according to the SEAPI score. Postoperative de novo urge incontinence was not found. Complication included suprapublic pain in 4 patients and transient urinary retention in 7 patients, but these were disappeared later in all patients. Operations with allograft fascia lata slings were tolerated, and neither infection nor erosion was encountered. CONCLUSIONS: Pubovaginal sling operation with a allograft cadaveric fascia lata is an effective treatment for stress urinary incontinence with high cure rate and minimal complication.