OBJECTIVE: The aim of this study was to present the results of pubovaginal sling with a low-cost polypropylene mesh in the treatment of stress urinary incontinence. MATERIALS AND METHODS: 118 women diagnosed with stress urinary incontinence (SUI) due to urethral hypermobility or intrinsic sphincteric deficiency, treated with pubovaginal sling (PVS) with a low-cost polypropylene mesh confectioned by the surgeon, were analyzed. All patients had a basic evaluation that included a medical history, physical examination, stress tests and urodynamic investigation. RESULTS: The average follow up was of 42 months. Urethral hypermobility was observed in 67% of the cases. The process was carried out on an outpatient basis on 67 patients. Intra-operative complications included 4 vesical injuries, treated with catheterization for 3 days. There were 13 early complications, of which 8 were urinary retentions treated with vesical drainage for 1 to 3 weeks and 3 vaginal extrusions of the mesh treated with covering of the sections with mucous membrane. There was a need for 6 urethrolysis in patients who presented irritative and postoperative obstructive symptoms; 81.3% of the patients were considered cured, while 9.3% had significant improvement. Three initially unsuccessful cases required sling reconfiguration. All cases were eventually cured. CONCLUSION: The construction of a pubovaginal sling using a low-cost polypropylene mesh is a safe and effective technique for the relief of SUI. It should be considered an alternative, especially for patients in public health systems with low financial resources.
OBJECTIVE: The aim of this study was to present the results of pubovaginal sling with a low-cost polypropylene mesh in the treatment of stress urinary incontinence. MATERIALS AND METHODS: 118 women diagnosed with stress urinary incontinence (SUI) due to urethral hypermobility or intrinsic sphincteric deficiency, treated with pubovaginal sling (PVS) with a low-cost polypropylene mesh confectioned by the surgeon, were analyzed. All patients had a basic evaluation that included a medical history, physical examination, stress tests and urodynamic investigation. RESULTS: The average follow up was of 42 months. Urethral hypermobility was observed in 67% of the cases. The process was carried out on an outpatient basis on 67 patients. Intra-operative complications included 4 vesical injuries, treated with catheterization for 3 days. There were 13 early complications, of which 8 were urinary retentions treated with vesical drainage for 1 to 3 weeks and 3 vaginal extrusions of the mesh treated with covering of the sections with mucous membrane. There was a need for 6 urethrolysis in patients who presented irritative and postoperative obstructive symptoms; 81.3% of the patients were considered cured, while 9.3% had significant improvement. Three initially unsuccessful cases required sling reconfiguration. All cases were eventually cured. CONCLUSION: The construction of a pubovaginal sling using a low-cost polypropylene mesh is a safe and effective technique for the relief of SUI. It should be considered an alternative, especially for patients in public health systems with low financial resources.
Authors: Mohammed S ElSheemy; Hisham Ghamrawy; Hesham Fathy; Hussein A Hussein; Eman A Hussein; Ahmed Aly; Sherif Abdel Rahman Journal: Arab J Urol Date: 2015-06-14