Long-term efficacy of the pubovaginal Mersilene mesh sling
Department of Obstetrics and Gynecology; Department of Medicine, Division of Preventive and Behavioral Medicine
Adult; Aged; Aged, 80 and over; Humans; Middle Aged; *Polyethylene Terephthalates; Prospective Studies; *Suburethral Slings; *Surgical Mesh; Urinary Incontinence, Stress
Obstetrics and Gynecology
OBJECTIVE: The objective of the study was to determine the efficacy of the pubovaginal Mersilene mesh sling (PVMMS) for complicated urodynamic stress incontinence (USI).
STUDY DESIGN: Between 1990 and 2008, patients with USI plus an at-risk diagnosis underwent a PVMMS by a single surgeon. They were followed up with urodynamics (UDE) and Pelvic Floor Distress Inventory-short form 20 (PFDI-20). Stratification was in an at-risk hierarchy: intrinsic sphincter deficiency (ISD) greater than recurrent USI (RUSI) greater than USI with chronically increased intraabdominal pressure (CI-IAP). A cough stress test determined objective cure. PFDI question 17 assessed subjective cure.
RESULTS: Three hundred six patients with ISD (43.5%), RUSI (26.8%), and CI-IAP (29.7%) had objective cure rates of 89.2% in the short term, 86.7% in the intermediate term, and 91.2% in the long term. A group of 48 patients with both short- and long-term UDEs showed cures of 100% and 91.7%. Long-term objective cure rates were: ISD, 90.5% (n = 21); RUSI, 84.2%, (n = 19); CI-IAP, 100% (n = 17). The mean score of postoperative PFDI question 17 was 0.57 (n = 119). Mean symptom improvement was -2.98 (n = 52; P < .0001).
CONCLUSION: We demonstrated PVMMS to be subjectively and objectively effective in long-term treatment of complicated forms of USI.
DOI of Published Version
Am J Obstet Gynecol. 2009 Nov;201(5):516.e1-7. Epub 2009 Sep 17. Link to article on publisher's site
American journal of obstetrics and gynecology
Young SB, Howard AE, Illanes DS, Weber Lebrun EE, Hardy JR, Kambiss SM, O'Dell KK, Zhang Y. (2009). Long-term efficacy of the pubovaginal Mersilene mesh sling. Obstetrics and Gynecology Publications. https://doi.org/10.1016/j.ajog.2009.07.003. Retrieved from https://escholarship.umassmed.edu/obgyn_pp/11