Pubovaginal Sling for the Treatment of Female Stress Urinary Incontinence

This is the authors' abstract. We don't add key points for this paper.

In Brief Introduction: We sought to identify our indications for a pubovaginal sling (PVS) in the midurethral synthetic sling era. Methods: Between June 2002 and July 2008, 369 consecutive, nonrandomized women underwent treatment for stress urinary incontinence with a sling surgery. Forty underwent PVS, while 329 midurethral slings were placed. This effort was focused on the reasons why PVS was chosen over a MUSS. Results: Mean patient age was 54.9 years (range, 21–86). Clinically, 69% presented with stress urinary incontinence and 31% with mixed urinary incontinence. The majority of the patients opted for a PVS for multiple previously failed incontinence surgeries 52.5%, followed by a fixed urethra 50%, concomitant surgeries involving urethral reconstruction 22.5%, compromised anatomy 18.7%, and abdominal surgery for a separate indication 5%. Forty-four percent (15/34) were cured, 17.6% (6/34) improved, 26.4% (9/34) failed, 6% (2/34) obstructed, and 6% (2/34) lost to follow-up. Conclusion: In the midurethral synthetic sling era, the PVS maintains its relevance in patients presenting with complex incontinent issues. The indications for a pubovaginal sling have evolved. In the midurethral sling era, the pubovaginal sling maintains its relevance in patients with complex incontinence issues.