Effects of pubovaginal sling procedure on patients with urethral hypermobility and intrinsic sphincteric deficiency: Would they do it again?

OBJECTIVE: This study was undertaken to assess the cure rate of stress urin ary incontinence, long-term effects on other tower urinary tract symptoms, and quality of life in a cohort of patients who underwent pubovaginal sling procedures for treatment of incontinence related to intrinsic sphincteric deficiency and urethral hypermobility. STUDY DESIGN: This was a retrospective analysis of 57 patients with 90% fol low-up who underwent pubovaginal autologous fascial sling procedures for st ress urinary incontinence related to urethral hypermobility and intrinsic s phincteric deficiency. Objective postoperative urodynamic evaluation was pe rformed in 34 (60%) of the cases. Telephone interviews to assess quality-of -life parameters were performed in all cases. RESULTS: The mean follow-up period was 42 months and the median follow-up p eriod was 34 months, with a range of 0.5 to 134 months. The age at the time of the sling procedure ranged from 18 to 84 years, with a median parity of 3.0 (range, 0-6). Preoperative body mass index ranged from 19.5 to 39.1 kg /m(2). Five percent or patients had detrusor instability before the operati on. Forty-one percent (41%) of the patients who underwent postoperative uro dynamic evaluation had voiding dysfunction. The postoperative objective cur e rate for stress urinary incontinence was 97%. Of all patients 88% indicat ed that the sling had improved the quality of life, 84% indicated that the sling relieved the incontinence in the long-term, and 82% would choose to u ndergo the procedure again. CONCLUSION: Construction of a pubovaginal sling nary incontinence. Voiding dysfunction is a common side effect. Despite this problem, of patients woul d elect to undergo the procedure again.