Outcomes Following PolyPropylene Mesh PuboVaginal Slings For Stress Urinary IncontinenceJan 4, 2001 Methods
Between 5/97 and 3/98, 56 consecutive women underwent a ProteGen sling placement in a community hospital setting by a single surgeon using a standard technique. Chart review and telephone interviews by an unbiased single interviewer based on a 13 point questionnaire were performed.
The follow-up ranged from 7-15 months (mean 13.0). Of the 56 women treated, 35 were contacted and completed the questionnaire. 18/56 (32.1%) of women had previous incontinence procedures. The short-term peri-operative complications included 5/56 (8.9%) related to SP tube placement, uri-nary retention requiring foley placement after the SP tube removal in 27/56 (48.2%) and UTIs in 23/56 (41.1%). The SP tube was left indwelling for a mean of 21.1 days (range 6 to 137). Long-term perioperative complications included sling erosions, pain and irritative/obstructive voiding symptoms. 15/56 (26.7%) of slings were eventually removed due to one of the above problems. Another 10/34 (29.4%) underwent a urethral dilation (UD) to improve symptoms. Remov-al of the sling occurred an average of 7.6 months (range 3-12) after its placement. Following removal, an anterior vesicouretheropexy (AVU) was performed in 8/12 women. Comparing women with
no post-operative procedure,
a post-sling UD
a sling removal, alone, and
a sling removal with an AVU, we found that, respectively,
8/13 (62%), 6/10 (60%), 5/6 (83%), 1/6 (18%) said they were the same or worse now than before the sling, 28/35 (80%) would not under-go the sling procedure again, and 8/35 (23%) still used more than one pad a day. Overall satisfaction and quality of life scores were highest for group 4.
Our study demonstrates that the ProteGen sling has a high rate of complications and patient dissatisfaction. Further investigation is needed to determine whether others have similar Results. The most satisfied group of women were those with slings removed and an additional anti-incontinence procedure performed.