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Published in: International Urogynecology Journal 4/2022

01-04-2022 | Stress Incontinence | Original Article

Very long-term follow-up of autologous pubovaginal fascia slings in women with stress urinary incontinence

Authors: Sandy Kim, Daniel G. Wong, Dominic Lee, Alana L. Christie, Philippe E. Zimmern

Published in: International Urogynecology Journal | Issue 4/2022

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Abstract

Introduction and hypothesis

The objective was to report on the very long-term outcome of a published series of autologous pubovaginal slings (PVS) in women with stress urinary incontinence (SUI).

Methods

Following institutional review board approval, a cohort of well characterized, non-neurogenic women who underwent an autologous PVS (primary [PVS1] and secondary [PVS2]) for SUI was re-evaluated for their very long-term outcome status. Data collected included demographics, validated questionnaires (Urogenital Distress Inventory – short form [UDI-6], Incontinence Impact Questionnaire – short form 7, quality of life), SUI retreatment/operations, and subjective patient-reported SUI improvement (%) and symptom recurrence. The primary outcome was success defined as UDI-6 question 3 (SUI) ≤ 1 and no SUI retreatment/operation. Patients not seen in clinic for 2 years were contacted via a standardized phone interview.

Results

From 83 patients with 7-year intermediate follow-up data, 34 (PVS1 = 18, PVS2 = 16) had very long-term follow-up based on clinic visit (7) or phone interviews (27). Those lost to follow-up (49), including 5 deceased, did not differ in demographics and intermediate outcomes from the followed cohort, but lived further away (>75 miles). At a mean age of 74 years, and with a median follow-up of 14.5 years, 53% met the success criteria (PVS1 = 44%, PVS2 = 63%). Mean postoperative questionnaire scores did not differ significantly between intermediate and very long-term follow-ups, and long-term outcomes between PVS1 and PVS2 remained similar.

Conclusions

A majority of women with long-term follow-up after PVS for primary and secondary SUI remained successful more than 14 years after their surgery. Both groups, PVS1 and PVS2, fared equally well, confirming the durability of PVS as a treatment alternative for SUI.
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Metadata
Title
Very long-term follow-up of autologous pubovaginal fascia slings in women with stress urinary incontinence
Authors
Sandy Kim
Daniel G. Wong
Dominic Lee
Alana L. Christie
Philippe E. Zimmern
Publication date
01-04-2022
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 4/2022
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-021-04737-7

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