Results of Pubovaginal Sling for the Treatment of Intrinsic Sphincteric Deficiency Determined by Questionnaire Analysis

PURPOSE: We evaluated by questionnaire analysis the success rate and overall patient satisfaction after pubovaginal sling surgery. MATERIALS AND METHODS: A total of 40 women (mean age 65.7 years, range 45 to 79) underwent pubovaginal sling surgery for stress urinary incontinence due to intrinsic sphincteric deficiency. Patients completed a detailed questionnaire to assess voiding symptoms, urinary control and satisfaction. Of 40 patients 37 (92.5%) returned the questionnaire, with a mean postoperative followup of 48.2 months (range 24 to 60). RESULTS: Patients with preoperative stress urinary incontinence alone were more likely to be dry than were patients with preoperative mixed incontinence (67% versus 36%, p < 0.001). Ten patients (27%) reported stress urinary incontinence recurrence. Of the patients 23 (62.2%) reported urgency symptoms at followup, with de novo urgency occurring in 4 patients. Permanent retention was noted in 3 patients, including 2 with sacral arc denervation. Overall patients reported 86% postoperative improvement in urinary continence, and 81% would recommend the operation. CONCLUSIONS: At mean 4-year followup after pubovaginal sling surgery, this outcome study using a self administered questionnaire confirms high patient satisfaction despite significant postoperative urgency symptoms.