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Pubovaginal slings for stress urinary incontinence following radical cystectomy and orthotopic neobladder reconstruction in women.
Although it is obvious to urogynecologists that the use of mesh in pubovaginal slings and abdominal sacrocolpopexies is fundamentally safe, according to substantial, reliable data, that fact doesn't matter.
In most clinical scenarios, rather than validating the patients' concerns about the safety of synthetic mesh and performing a pubovaginal sling procedure, the most appropriate course of action is detailed, evidence-based patient education about MUS safety and efficacy to counter the patient's misperceptions of safety concerns.
Although the pubovaginal sling procedure was pioneered as a surgical option for intrinsic sphincter deficiency (ISD), its indications have broadened to encompass all types of SUI.
Hypermobility is one of the most common causes of SUI in women; however, there does not appear to be any statistically significant difference for the transobturator and retropubic MUS, or the pubovaginal sling in the treatment success rates for women with SUI secondary to urethral hypermobility.
PELVIC PROLAPSE' RECONSTRUCTION was performed; surgery included a pubovaginal sling procedure with graft, and repairs of Grade 2 cystocele and Grade 3 rectocele.
Older women who undergo Burch colposuspension or pubovaginal sling procedure for the treatment of stress urinary incontinence can expect perioperative outcomes similar to those for younger women, but they are more likely to experience continued symptoms and to need retreatment by 2 years, based on a secondary analysis involving 655 women.
The autologous fascia pubovaginal sling for complicated female stress incontinence.
That's why the quoted high initial success rates-often 80%-90%--for the Burch procedure, variations on the pubovaginal sling operations, needle suspensions, and other traditional procedures often give way to a mere 50% or so long-term cure rate without subsequent problems.
While the total number of SUI surgeries remained stable, the use of autologous fascia pubovaginal sling increased.
The study that compares the pubovaginal sling, TVT, and TOT for stress urinary incontinence with ISD is not the first to show that the transobturator approach is much less effective (35% cure at 2 years) than either TVT or the pubovaginal sling (87% each).
The investigators assumed that all patients with genuine or mixed incontinence or intrinsic sphincter deficiency would get a pubovaginal sling in addition to any prolapse repair procedure.