Polypropylene mesh used as a pubovaginal sling in the treatment of female stress urinary incontinence — Preliminary experience

Abstract

There is some lack of consensus regarding the best method to treat female patients with stress urinary incontinence (SUI). In the past, pubovaginal slings were reserved for recurrent, complicated cases associated with intrinsic sphincteric deficiency, but this is not the case any more. We report our own experience using the polypropylene mesh in the treatment of all types of SUI in women. 25 female patients with a mean age of 42.1 ± 9.7 (range 26–70) years were included in this prospective study. Pre-operative evaluation included a detailed uro-gynecological history, voiding diary, physical examination, laboratory investigations and multichannel urodynamics. A pubovaginal sling procedure using polypropylene mesh was performed in all patients. Post-operatively, the patients were evaluated at 1, 3, 6 months and then at 3-month intervals. Post-operative urodynamic assessment was done only in the presence of urgency or urge incontinence, whether persistent or de novo, recurrent SUI and persistent obstruction. At a mean follow-up of 25.2 (range 20–30) months, 21 patients (84%) were cured, 3 patients were improved (12%) and the procedure failed in one patient. Post-operative urinary urge incontinence was present in 4 patients (16%) including 3 patients with pre-operative urgency/urge incontinence and one patient with de-novo urgency/urge incontinence. Complications included urinary retention in 6 and bladder perforation in 2 patients. The results achieved with the polypropylene sling are comparable to other procedures reported in the literature. It represents an inexpensive, safe and simple alternative treatment for patients with SUI.