Experience with pubovaginal slings for urinary incontinence at the University of Michigan.

In July 1983 pubovaginal slings were used first at our university to treat incontinence in female patients with poor urethral function. From then until July 1, 1986, 82 such procedures were performed on a diverse group of patients, including a male patient. Initial success occurred postoperatively in 67 patients, with 15 failures. Of these failures 7 were related to urethral dysfunction. Another sling procedure was done in 2 patients and they are continent, while 3 were treated with medication: 2 became dry and 1 remains wet. A total of 8 patients suffered detrusor-related incontinence postoperatively (2 required augmentation cystoplasty for poor bladder compliance). To date 78 patients (95 per cent) are continent. Of the patients 2 required periodic intermittent catheterization for more than a year postoperatively and 12 are managed by chronic intermittent self-catheterization on a planned basis for neurogenic vesical dysfunction.