Comparison between Anterior Vaginal Wall Sling and Pubovaginal Sling Using Cadaveric Fascia Lata for the Treatment of Female Sphincteric Incontinence / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Sling procedure has been performed mainly in stress urinary incontinence (SUI) patients with intrinsic sphincteric deficiency (ISD). The purpose of this study was to compare the safety and efficacy of anterior vaginal wall sling with pubovaginal sling using cadaveric fascia lata in the treatment of women with ISD. MATERIALS AND METHODS: Among 43 patients with ISD who had received sling procedure, we retrospectively compared 21 women treated with anterior vaginal wall sling (Group A) to 22 women treated with pubovaginal sling using cadaveric fascia lata (Group B). Preoperative evaluations included cystourethrography, urodynamic study and incontinence staging with SEAPI (stress-related leakage, emptying ability, anatomy, protection and inhibition) classification. The operation time, rate of complication, duration of suprapubic catheterization, length of hospital stay, postoperative presence of stress or urge incontinence, and satisfaction scores were checked. RESULTS: In group A, 17 patients (81.0%) were cured and 3 (14.3%) showed improvement within 14.2 months of mean follow-up, whereas in group B, 18 patients (81.8%) were cured and 3 (13.6%) showed improvement within 13.5 months. De novo urgency was presented in 2 patients (9.5%) from group A and 1 (4.5%) from group B. There was no statistically significant difference between the 2 groups in terms of complication rates and postoperative subjective SEAPI scores. CONCLUSIONS: We concluded that anterior vaginal wall sling and pubovaginal sling using cadaveric fascia lata are both effective surgical treatments for SUI with ISD.