Pubovaginal sling surgery for simple stress urinary incontinence: Analysis by an outcome score

Asnat Groutz, Jerry G. Blaivas, Michael J. Hyman, David Chaikin

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Purpose: We assessed the results of pubovaginal sling surgery in women with simple stress urinary incontinence using strict subjective and objective criteria. Materials and Methods: Simple incontinence was defined as sphincteric incontinence with no concomitant urge incontinence, pipe stem or fixed scarred urethra, urethral or vesicovaginal fistula, urethral diverticulum, grade 3 or 4 cystocele, or neurogenic bladder. A total of 67 consecutive women with a mean age plus or minus standard deviation of 56 ± 11 years who underwent pubovaginal sling surgery for simple sphincteric incontinence were prospectively followed for 12 to 60 months (mean 33.9 ± 22.2). Treatment outcomes were classified according to a new outcome score. Cure was defined as no urinary loss due to urge or stress incontinence, as documented by 24-hour diary and pad test, with the patient considering herself cured. Failure was defined as poor objective results with the patient considering surgery to have failed. Cases that did not fulfill these cure-failure criteria were considered improved and further classified into a good, fair or poor response. Results: Of the 67 patients 46 (69%) had type II and 21 (31%) had type III incontinence. Preoperative diary and pad tests revealed a mean of 5.9 ± 3.6 stress incontinence episodes and a mean urinary loss of 91.8 ± 81.9 gm. per 24 hours. There were no major intraoperative, perioperative or postoperative complications. Two patients (3%) had persistent minimal stress incontinence and 7 (10%) had new onset urge incontinence within 1 year after surgery. Overall using the strict criteria of our outcome score 67% of the cases were classified as cured and the remaining 33% were classified as improved. The degree of improvement was defined as a good, fair and poor response in 21%, 9% and 3% of patients, respectively. Conclusions: Mid-term outcome results defined by strict subjective and objective criteria confirm that the pubovaginal sling is highly effective and safe surgery for simple sphincteric incontinence. A follow-up of more than 5 years is required to establish the long-term durability of this procedure.

Original languageEnglish (US)
Pages (from-to)1597-1600
Number of pages4
JournalJournal of Urology
Volume165
Issue number5 I
StatePublished - Jan 1 2001
Externally publishedYes

Fingerprint

Stress Urinary Incontinence
Urge Urinary Incontinence
Cystocele
Vesicovaginal Fistula
Neurogenic Urinary Bladder
Diverticulum
Intraoperative Complications
Urethra

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Groutz, Asnat ; Blaivas, Jerry G. ; Hyman, Michael J. ; Chaikin, David. / Pubovaginal sling surgery for simple stress urinary incontinence : Analysis by an outcome score. In: Journal of Urology. 2001 ; Vol. 165, No. 5 I. pp. 1597-1600.
@article{fc022503bb18469c85b1b939554d501f,
title = "Pubovaginal sling surgery for simple stress urinary incontinence: Analysis by an outcome score",
abstract = "Purpose: We assessed the results of pubovaginal sling surgery in women with simple stress urinary incontinence using strict subjective and objective criteria. Materials and Methods: Simple incontinence was defined as sphincteric incontinence with no concomitant urge incontinence, pipe stem or fixed scarred urethra, urethral or vesicovaginal fistula, urethral diverticulum, grade 3 or 4 cystocele, or neurogenic bladder. A total of 67 consecutive women with a mean age plus or minus standard deviation of 56 ± 11 years who underwent pubovaginal sling surgery for simple sphincteric incontinence were prospectively followed for 12 to 60 months (mean 33.9 ± 22.2). Treatment outcomes were classified according to a new outcome score. Cure was defined as no urinary loss due to urge or stress incontinence, as documented by 24-hour diary and pad test, with the patient considering herself cured. Failure was defined as poor objective results with the patient considering surgery to have failed. Cases that did not fulfill these cure-failure criteria were considered improved and further classified into a good, fair or poor response. Results: Of the 67 patients 46 (69{\%}) had type II and 21 (31{\%}) had type III incontinence. Preoperative diary and pad tests revealed a mean of 5.9 ± 3.6 stress incontinence episodes and a mean urinary loss of 91.8 ± 81.9 gm. per 24 hours. There were no major intraoperative, perioperative or postoperative complications. Two patients (3{\%}) had persistent minimal stress incontinence and 7 (10{\%}) had new onset urge incontinence within 1 year after surgery. Overall using the strict criteria of our outcome score 67{\%} of the cases were classified as cured and the remaining 33{\%} were classified as improved. The degree of improvement was defined as a good, fair and poor response in 21{\%}, 9{\%} and 3{\%} of patients, respectively. Conclusions: Mid-term outcome results defined by strict subjective and objective criteria confirm that the pubovaginal sling is highly effective and safe surgery for simple sphincteric incontinence. A follow-up of more than 5 years is required to establish the long-term durability of this procedure.",
author = "Asnat Groutz and Blaivas, {Jerry G.} and Hyman, {Michael J.} and David Chaikin",
year = "2001",
month = "1",
day = "1",
language = "English (US)",
volume = "165",
pages = "1597--1600",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "5 I",

}

Pubovaginal sling surgery for simple stress urinary incontinence : Analysis by an outcome score. / Groutz, Asnat; Blaivas, Jerry G.; Hyman, Michael J.; Chaikin, David.

In: Journal of Urology, Vol. 165, No. 5 I, 01.01.2001, p. 1597-1600.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pubovaginal sling surgery for simple stress urinary incontinence

T2 - Analysis by an outcome score

AU - Groutz, Asnat

AU - Blaivas, Jerry G.

AU - Hyman, Michael J.

AU - Chaikin, David

PY - 2001/1/1

Y1 - 2001/1/1

N2 - Purpose: We assessed the results of pubovaginal sling surgery in women with simple stress urinary incontinence using strict subjective and objective criteria. Materials and Methods: Simple incontinence was defined as sphincteric incontinence with no concomitant urge incontinence, pipe stem or fixed scarred urethra, urethral or vesicovaginal fistula, urethral diverticulum, grade 3 or 4 cystocele, or neurogenic bladder. A total of 67 consecutive women with a mean age plus or minus standard deviation of 56 ± 11 years who underwent pubovaginal sling surgery for simple sphincteric incontinence were prospectively followed for 12 to 60 months (mean 33.9 ± 22.2). Treatment outcomes were classified according to a new outcome score. Cure was defined as no urinary loss due to urge or stress incontinence, as documented by 24-hour diary and pad test, with the patient considering herself cured. Failure was defined as poor objective results with the patient considering surgery to have failed. Cases that did not fulfill these cure-failure criteria were considered improved and further classified into a good, fair or poor response. Results: Of the 67 patients 46 (69%) had type II and 21 (31%) had type III incontinence. Preoperative diary and pad tests revealed a mean of 5.9 ± 3.6 stress incontinence episodes and a mean urinary loss of 91.8 ± 81.9 gm. per 24 hours. There were no major intraoperative, perioperative or postoperative complications. Two patients (3%) had persistent minimal stress incontinence and 7 (10%) had new onset urge incontinence within 1 year after surgery. Overall using the strict criteria of our outcome score 67% of the cases were classified as cured and the remaining 33% were classified as improved. The degree of improvement was defined as a good, fair and poor response in 21%, 9% and 3% of patients, respectively. Conclusions: Mid-term outcome results defined by strict subjective and objective criteria confirm that the pubovaginal sling is highly effective and safe surgery for simple sphincteric incontinence. A follow-up of more than 5 years is required to establish the long-term durability of this procedure.

AB - Purpose: We assessed the results of pubovaginal sling surgery in women with simple stress urinary incontinence using strict subjective and objective criteria. Materials and Methods: Simple incontinence was defined as sphincteric incontinence with no concomitant urge incontinence, pipe stem or fixed scarred urethra, urethral or vesicovaginal fistula, urethral diverticulum, grade 3 or 4 cystocele, or neurogenic bladder. A total of 67 consecutive women with a mean age plus or minus standard deviation of 56 ± 11 years who underwent pubovaginal sling surgery for simple sphincteric incontinence were prospectively followed for 12 to 60 months (mean 33.9 ± 22.2). Treatment outcomes were classified according to a new outcome score. Cure was defined as no urinary loss due to urge or stress incontinence, as documented by 24-hour diary and pad test, with the patient considering herself cured. Failure was defined as poor objective results with the patient considering surgery to have failed. Cases that did not fulfill these cure-failure criteria were considered improved and further classified into a good, fair or poor response. Results: Of the 67 patients 46 (69%) had type II and 21 (31%) had type III incontinence. Preoperative diary and pad tests revealed a mean of 5.9 ± 3.6 stress incontinence episodes and a mean urinary loss of 91.8 ± 81.9 gm. per 24 hours. There were no major intraoperative, perioperative or postoperative complications. Two patients (3%) had persistent minimal stress incontinence and 7 (10%) had new onset urge incontinence within 1 year after surgery. Overall using the strict criteria of our outcome score 67% of the cases were classified as cured and the remaining 33% were classified as improved. The degree of improvement was defined as a good, fair and poor response in 21%, 9% and 3% of patients, respectively. Conclusions: Mid-term outcome results defined by strict subjective and objective criteria confirm that the pubovaginal sling is highly effective and safe surgery for simple sphincteric incontinence. A follow-up of more than 5 years is required to establish the long-term durability of this procedure.

UR - http://www.scopus.com/inward/record.url?scp=0035047625&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035047625&partnerID=8YFLogxK

M3 - Article

C2 - 11342925

AN - SCOPUS:0035047625

VL - 165

SP - 1597

EP - 1600

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 5 I

ER -