Sa. Kaplan et al., COMPARISON OF FASCIAL AND VAGINAL WALL SLINGS IN THE MANAGEMENT OF INTRINSIC SPHINCTER DEFICIENCY, Urology, 47(6), 1996, pp. 885-889
Objectives. To compare safety and efficacy of fascial versus vaginal w
all slings in the management of women with intrinsic sphincter deficie
ncy (ISD). Methods. The hospital and office records of 79 consecutive
women with ISD were retrospectively analyzed from January 1991 to Sept
ember 1995. There were 43 fascial slings (group A) and 36 vaginal wall
slings (group B). Parameter of evaluation included efficacy based on
postoperative presence of stress or urge incontinence and number of pa
ds used, complications, and miscellaneous factors, including length of
catheterization time, length of hospitalization, quantity of analgesi
cs used, and loss of work days. Results. Baseline clinical and urodyna
mic data were the same for both groups. Pad use decreased from 6.9 to
0.6 for group A and from 5.7 to 0.3 for group B. Persistent stress and
urge incontinence was present in 5% and 16% of group A patients and i
n 3% and 11% of group B patients, respectively. Group A (89%) and grou
p B (94%) patients were either very satisfied or satisfied with their
surgical outcome. The operative time, hospital days, and days lost fro
m work for group B patients (42.3 +/- 13.4 minutes, 1.4 +/- 0.9 days,
18.4 +/- 3.2 days, respectively) were significantly lower than for gro
up A patients (84.2 +/- 17.8 minutes, 3.7 +/- 1.9 days, 28.4 +/- 7.8 d
ays, respectively). Conclusions. Both fascial and vaginal wall slings
are effective in treating women with ISD. However, the use of vaginal
wall slings resulted in significantly shorter hospital stay, decreased
catheterization time, decreased use of analgesics, and decreased loss
of days of work compared with fascial slings. Therefore, the vaginal
wall sling should be the preferred surgical method of treating intrins
ic sphincter deficiency.