THE POLYPROPYLENE PUBOVAGINAL SLING FOR THE TREATMENT OF RECURRENT STRESS URINARY-INCONTINENCE

Purpose: The significance of a 2-team approach to the problems of recu rrent incontinence in patients with extensive pelvic scarring from pre vious surgery is emphasized. Materials and Methods: We reviewed 88 con secutive patients who presented between January 1986 and November 1992 . The demonstration of a scarred, wide open, proximal urethra or drain pipe urethra was the important selection criterion. Two teams, 1 oper ating abdominally and 1 vaginally, released the bladder neck from its bed of scar under direct vision and set the sling in place with minima l tension at the bladder neck. Results: Of the women 75 (85.2%) were c ured of the stress urinary incontinence and 8 (9.1%) had improvement w ith mainly urge incontinence, while 5 (5.7%) operations failed. There was a significant association between chronic chest disease and failur e. Conclusions: The 2-team polypropylene (Marlex) mesh approach contin ues to be an effective treatment for women with complicated stress uri nary incontinence.