Autologous Pubovaginal Fascial Sling for Female Anatomical Incontinence: Success Rate and Risk Factors / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Because of the disappointing long-term results of transvaginal bladder neck suspension surgery for anatomical incontinence (AI), a pubovaginal sling, which was formerly operated for sphincteric incontinence (SI), was used to treat AI. The results of the pubovaginal sling for treating AI and the risk factors that affect the result were evaluated. MATERIALS AND MTHODS A total 39 women with AI underwent a pubovaginal fascial sling using a strip of autologous rectus muscle fascia. The urethral sphincteric function was assessed by measuring the Valsalva leak point pressure. Fifteen patients has type I and 24 patients type II stress incontinence. The results of the pubovaginal sling were compared with those of 51 women who received the Raz precedure. The risk factors for the pubovaginal fascial sling were evaluated. RESULTS: The success rate of an autologous pubovaginal sling (95.6%) at mean follow-up period of (21 months) was significantly higher than that of the Raz bladder neck suspension (80.4%) during the same follow-up period (p<0.05). The success rate of the Raz procedure - 80.4%, 70.8% and 60.7% at 21, 36, 72 months - was decreased after months. The predictive factors for the pubovaginal sling - the number of deliveries, history of hystectomy, the type of stress incontinence, cystocele, urge incontinence, and age - had no significant effect on the success rate of the pubovaginal sling (p<0.05). CONCLUSIONS: A pubovaginal fascial sling may be an effective surgical treatment not only for treating sphincteric incontinence but also anatomical incontinence.