J Med Assoc Thai 2001; 84 (10):1412

Views: 955 | Downloads: 19 | Responses: 0

PDF XML Respond to this article Print Alert & updates Request permissions Email to a friend


Pubovaginal Sling for the Treatment of Female Stress Urinary Incontinence: Experience of 100 Cases at Ramathibodi Hospital
Kochakarn W Mail, Leenanupunth C , Ratana0arn K , Roongreungsilp U , Siripornpinyo N

Objective
: To evaluate the outcome of pubovaginal sling procedure for treatment of
female stress urinary incontinence.
Material and Method
: From September 1997 to January 2000, one hundred consecutive
patients with urodynamically proven stress incontinence had a pubovagina1 sling procedure per-
formed. Operative technique, intraoperative and post-operative complications, voiding patterns,
residual urine as well as the follow-up course were reviewed.
Results
: Of one hundred cases, the mean patient age was 52.6 years old (range 34-73).
The etiologies of stress incontinence were 85 cases of urethral hypermobility and 15 cases of
intrinsic sphincter deficiency (ISD). Eighteen cases were after failure of prior continence proce-
dures. No intraoperative and post-operative complications were found except one case of wound
infection. Minimal bleeding was noted. Marked post-operative residual urine (>100 ml) was found in
39 cases and clean intermittent catheterization was used. The mean time for catheterization was 8.9
weeks (range 2-12 weeks). The mean time to follow-up was 12.1 months (range 4-36 months).
Ninety-four cases had been completely dried in the follow-up period since the last visit and 5 cases
had much improvement of incontinence using only 1-2 pads/day. Only one case was found to have
failed the procedure.
De novo
instability was found in 5 cases.
Conclusion
: On the basis of these results, we propose that pubovaginal sling is an effec-
tive treatment for female stress incontinence with very few complications.
Key word
: Pubovaginal Sling, Stress Urinary Incontinence, Surgery

Download: PDF