1188 LONG-TERM DURABILITY OF THE DISTAL URETHRAL POLYPROPYLENE SLING PROCEDURE FOR STRESS URINARY INCONTINENCE: MINIMUM 10-YEAR FOLLOW-UP

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence - Evaluation & Therapy II1 Apr 20121188 LONG-TERM DURABILITY OF THE DISTAL URETHRAL POLYPROPYLENE SLING PROCEDURE FOR STRESS URINARY INCONTINENCE: MINIMUM 10-YEAR FOLLOW-UP Lisa Rogo-Gupta, Z. Chad Baxter, Ngoc-Bich Le, Shlomo Raz, and Larissa V. Rodriguez Lisa Rogo-GuptaLisa Rogo-Gupta Los Angeles, CA More articles by this author , Z. Chad BaxterZ. Chad Baxter Los Angeles, CA More articles by this author , Ngoc-Bich LeNgoc-Bich Le Los Angeles, CA More articles by this author , Shlomo RazShlomo Raz Los Angeles, CA More articles by this author , and Larissa V. RodriguezLarissa V. Rodriguez Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1433AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We report on the long-term outcomes of the distal urethral polypropylene sling (DUPS) for stress urinary incontinence (SUI). METHODS We performed a prospective study of all consecutive patients who underwent a DUPS procedure between November of 1999 and April of 2000 for treatment of SUI. One and five year outcomes for this particular patient cohort have been previously reported. This cohort was followed prospectively and at a minimum of 10-yr follow-up, outcome was determined by patient self-assessment including validated symptom and bother questionnaires (Incontinence Symptom Score and Urogenital Distress Inventory). RESULTS There were 69 patients followed prospectively. Mean age at the time of surgery was 62 years (range 29-86). Mean age at follow-up was 73 years (range 40-97). At a minimum follow-up of 10 years, patient determined subjective success rate was 69%. Patients reported an overall mean improvement in symptoms of 63%, with 46% of patients reporting >90% improvement. This compared to a success rate of 88% and an overall mean improvement of symptoms of 81% at 5 years. More than 10 years after surgery, 82% of patients reported SUI occurred never or less than once per week. 80% of patients reported never or slightly being bothered by SUI. This compared to 93% and 84% of patients who reported SUI occurred never or less than once per week, and 93% and 86% who reported never or slightly being bothered by SUI, at 5 years and 1 year, respectively. Of patients age <48 years at the time of surgery, 100% were able to respond at the time of long-term follow-up, compared to 67% of patients age 49-74, and 40% of patients age >75. The remaining patients were unable to respond due to cognitive limitations or were deceased within the follow-up period. CONCLUSIONS The DUPS procedure has excellent long-term durability in treating patients with SUI, in addition to the low morbidity and low cost previously described. Ten years after their procedure the majority of patients report symptom improvement. Nevertheless, a significant number of older patients undergoing surgery for SUI are unable to follow up 10 years after surgery due to cognitive limitations or death. When choosing an anti-incontinence procedure, effectiveness and durability need to be considered in light of patient age given the theoretical advantages of long term durability are limited by cognitive decline and mortality. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e481 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lisa Rogo-Gupta Los Angeles, CA More articles by this author Z. Chad Baxter Los Angeles, CA More articles by this author Ngoc-Bich Le Los Angeles, CA More articles by this author Shlomo Raz Los Angeles, CA More articles by this author Larissa V. Rodriguez Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...