Objectives. To assess the long-term results of a transvaginal endoscopic Go
re-Tex patch sling in women with genuine stress urinary incontinence due to
urethral hypermobility and/or intrinsic sphincter deficiency, with or with
out coexistent urge incontinence.
Methods. Between December 1989 and June 1994, we performed a Gore-Tex patch
sling procedure in 141 consecutive women. All patients had documented stre
ss urinary incontinence on preoperative videourodynamic testing. We conduct
ed outcomes analysis using the information from postoperative office visits
, detailed chart reviews, patient questionnaires, and telephone surveys.
Results. A complete follow-up was available in 90 patients. The mean follow
-up was 51 months (range 27 to 84). Their mean age was 54.2 years (range 32
to 86). Stress incontinence was completely cured in 80 (88.9%) of 90 patie
nts. Pure stress incontinence persisted in 4 (4.4%) of 90 patients. Mixed i
ncontinence occurred in 6 (6.7%) of 90 patients. Pure urge incontinence was
experienced by 16 (17.8%) of 90 patients. Six patients required incision o
f the Core-Tex patch for obstruction or retention; 3 remain continent. Five
patients developed vaginal granulation tissue requiring Gore-Tex patch rem
oval; 1 remains continent. There was no bladder or urethral erosion.
Conclusions. The transvaginal Gore-Tex patch sling has provided durable eff
icacy with minimal morbidity for the treatment of stress urinary incontinen
ce due to anatomic urethral hypermobility and/or intrinsic sphincter defici
ency. UROLOGY 54: 641-646, 1999. (C) 1999, Elsevier Science Inc.