Long-Term Durability of the Distal Urethral Polypropylene Sling for the Treatment of Stress Urinary Incontinence: Minimum 11-Year Followup

• Published in: The Journal of urology Vol. 188; no. 5; pp. 1822 - 1827
• Main Authors: Rogo-Gupta, Lisa, Baxter, Z. Chad, Le, Ngoc-Bich, Raz, Shlomo, Rodríguez, Larissa V
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2012; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Female; Humans; Materials Testing; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Polypropylenes; Prospective Studies; Prosthesis Design; stress; Suburethral Slings; Time Factors; treatment outcome; urethra; urinary incontinence; Urinary Incontinence, Stress - surgery; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Urology; stress; urge urinary incontinence; stress urinary incontinence; suburethral slings; SUI; CCI; UUI; tension-free vaginal tape; urethra; urinary incontinence; treatment outcome; Charlson comorbidity index; TVT; DUPS; distal urethral polypropylene sling; Nephrology; Urinary system disease; Prognosis; Suburethral sling; Sling operation; Propylene polymer; Durability; Urinary tract disease; Long term; Stress; Urology; Urinary incontinence; Voiding dysfunction; Treatment; Urethra; Surgery; Distal; Bladder disease; Urinary stress incontinence
• ISSN: 0022-5347; 1527-3792
• DOI: 10.1016/j.juro.2012.07.033

Purpose We report on the long-term outcomes of the distal urethral polypropylene sling for stress urinary incontinence in a patient cohort that was closely followed and whose outcomes were reported at 1 and 5 years after surgery. Materials and Methods We performed a prospective study of all consecutive patients who underwent a distal urethral polypropylene sling procedure between November 1999 and April 2000. The 1 and 5-year outcomes for this particular patient cohort were previously reported. At the minimum 11-year followup, outcome was determined by patient self-assessment including validated questionnaires. Results A total of 69 patients were followed prospectively and followup was obtained for 30. Of those lost to followup 10 were deceased and 5 were cognitively impaired. Mean patient age at followup was 73 years (range 40 to 97). More than 11 years after surgery 48% of patients reported no stress urinary incontinence symptoms and 63% were never bothered by stress urinary incontinence. Patients reported a mean overall symptom improvement of 64% compared to 81% at 5 years. Overall 82% of patients met the criteria for treatment success by symptom scores and 80% met the criteria by bother scores. Conclusions The distal urethral polypropylene sling procedure has excellent long-term durability in the treatment of stress urinary incontinence, in addition to low morbidity and low cost as previously described. Eleven years after the procedure the majority of patients report symptom improvement. Nevertheless, many older patients are unable to participate in followup. When choosing an anti-incontinence procedure, durability should be considered in light of patient age given that the theoretical advantages of long-term durability are limited by cognitive decline and mortality.