OUR EXPERIENCE WITH PUBOVAGINAL SLINGS IN PATIENTS WITH STRESS URINARY-INCONTINENCE

Purpose: Pubovaginal slings successfully treat stress urinary incontin ence in women with intrinsic sphincter deficiency. Because of its dura bility, it has been an attractive procedure in select patients with ur ethral hypermobility. We examine our experience with pubovaginal sling . Materials and Methods: A total of 150 patients were evaluated for pe lvic prolapse and urinary incontinence. An abdominal leak point pressu re was determined in all patients. Of patients with type II stress uri nary incontinence, 36 patients (80%) underwent additional gynecologica l procedures at the time of the pubovaginal sling, compared to 29% wit h intrinsic sphincter deficiency and 33% with coexisting urethral hype rmobility and intrinsic sphincter deficiency. Results: The overall cur e rate was 93% with a mean followup of 22 months. At 1 week postoperat ively spontaneous voiding was accomplished by 56% of the patients with urethral hypermobility and 57% with intrinsic sphincter deficiency. O nly 2.8% of patients required surgical therapy for prolonged urinary r etention. De novo urgency/urge incontinence occurred in 19% of women w ith a 3% incidence of persistent urge incontinence. Conclusions: Pubov aginal slings are effective and durable. Voiding dysfunction is uncomm on and is temporary in most patients.