Long-term Results of the Acellular Human Dermal Allograft Sling With Transvaginal Bone Anchors

Abstract

In Brief Objectives: We reviewed the long-term results of an acellular human dermal allograft (Repliform; Boston Scientific, Natick, MA) sling with transvaginal bone anchors for the treatment of stress urinary incontinence. Materials and Methods: A retrospective analysis was performed on 61 consecutive patients who underwent a transvaginal sling with an acellular human dermal allograft and transvaginal bone anchors for stress urinary incontinence. All procedures were performed by one surgeon (T.L.). Postoperatively, all patients received a questionnaire evaluating continence, pelvic pain, and satisfaction with the procedure. Patients who did not return the questionnaire were contacted by phone (if they could be located) and encouraged to participate. Results: Thirty-one of the 61 patients completed the questionnaire for a response rate of 51%. Follow up ranged from 14 to 63 months (mean, 33.5 months). Of the group that responded, 22.5% reported being completely dry and 70.9% reported incontinence with minimal to moderate activity. Forty-eight percent of patients report using one or more pads per day, whereas 19% never use a pad. Forty-five percent report being satisfied with the procedure. Fifty-one percent report that their urinary control is significantly better, whereas 9% report it is worse. No patient developed osteitis pubis but 4 (12.9%) developed dyspareunia. Conclusion: We conclude that the transvaginal sling with an acellular human dermal allograft and the use of bone anchors has poor long-term results as an antiincontinence procedure. The use of bone anchors did not seem to increase the risk of osseous complications. Long-term outcomes with a human dermal allograft sling with bone anchors are reviewed. At an average follow-up of 33.5 months 71% of patients experienced incontinence with minimal to moderate activity.