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2000, Number 3

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Rev Med Hosp Gen Mex 2000; 63 (3)

Sling suspension in urinary stress incontinence. Experience in the Hospital General de México, Department of urology

Cisneros-Madrid B, Gutiérrez-Godinez FA, González-Pérez A, Vásquez-Lastra C, Arce-Alcázar A, Sentíes-Hernández I, Reyna-Pérez R, Soria-Fernández G

Language: Spanish
References: 22
Page: 171-177
PDF size: 140.86 Kb.


ABSTRACT

Objective: To demonstrate de effectiveness in the treatment of urinary incontinence type 3 using the Sling technique and to prevent complications while using this approach. Material and methods: We use a prospective and retrospective analysis of 13 patients in the Urology Department of the Hospital General de Mexico with diagnosis of urinary incontinence type 3 who received a Sling procedure. These patients were evaluated preoperatively with a complete neurological clinical examination, physical examination, urinary incontinence question format, Urinalysis, urine culture and vaginal culture. They also were submitted to cistoscopy, Bonney-Marshall test and urodynamic study. Results: 13 Sling procedures were made, finding 12 urinary incontinence type 3 (92%) and only 1 case of mixed urinary incontinence (7.6%). The average age was 46.8 years, ranging from 31 to 72 years. The cure percentage was 92% (12 cases). Presenting urinary urgency incontinence in 1 case managed with anticholinergic medication. Conclusions: The Sling procedure is an effective treatment, useful in the urinary incontinence due to intrinsic sphinteric deficiency (type 3) and in those cases of preceding incontinence surgery, with a success rate of 92%. The basic complication inherent to the procedure was vesical instability, which was temporal in 46% of the cases, responding to medical treatment. The second complication which we reported was infravesical obstruction, documented with urodynamic studies, in 38% of the cases. These later cases presented with urinary retention, and had in common not using cistoscopic control during surgery.


REFERENCES

  1. Chaikin DC, Rosenthal J et al. Pubovaginal fascial sling for all types of stress urinary incontinence: Long-term analysis. J Urol 1998; 160: 1312-1316.

  2. Bidmead J, Cardozo L. Four decades of needle bladder neck suspension. Br J Urol 1988; 82: 171-173.

  3. Bent SE, McLennan MT. Surgical management of urinary incontinence. Obstet Gynecol Clin N Am 1998; 25 (4): 883-906.

  4. Litwiller SE, Nelson RS, Fone PD. Vaginal wall sling: Long-term outcome analysis of factors contributing to patient satisfaction and surgical success. J Urol 1997; 157: 1279-1282.

  5. Ulf Ulmsten, Peter Petros. Intravaginal slingplasty (IVS): An ambulatory surgical procedure for treatment of female urinary incontinence. Sand J Nephrol 1995; 29: 75-82.

  6. Edward J, McGuire MD, Helen O’Connell. Surgical treatment of intrinsic urethral dysfunction. Urologic Clinics of North America 1995; 22 (3): 665-672.

  7. McGuire EJ, Letson W, Wang S. Transvaginal urethrolysis after obstructive urethral suspension procedures. J Urol 1989; 142: 1037-1039.

  8. Decter RM. Use of the Fascial Sling for Neurogenic incontinence: Lessons learned. J Urol 1993; 150: 683-686.

  9. Blaivas JG, Jacobs BZ. Pubovaginal fascial sling for the treatment of complicated stress urinary incontinence. J Urol 1991; 145: 1214-1218.

  10. Saad Juma, Nancy A. Little, Shlomo Raz. Vaginal wall Sling: fours years later. Urology 1992; XXXIX (5): 424-428.

  11. Mclennan MT, Melick CF, Bent AE. Clinical and urodynamic predictors of delayed voiding after fascia lata suburetral sling (part 1). Obstetr Gynecol 1998; 92 (4): 608-612.

  12. Carr LK, Walsh PJ, Abraham VE, Webster GD. Favorable outcome of pubovaginal Slings for geriatric women with stress incontinence. J Urol 1997; 157: 125-128.

  13. Walker RD, Flack CE, Hawkins-Lee B, Lim DJ. Rectus Fascial Wrap: Early Results of a modification of the rectus fascial sling. J Urol 1995; 154: 771-774.

  14. Richmond DH, Sutherst JR. Burch colspsuspension or sling for stress incontinence? A prospective study using transrectal ultrasound. Brit J Urol 1989; 64: 600-603.

  15. David R, Coullard KA, Deckard-Janatpour AR. Stone: The vaginal wall sling: A compressive suspension procedure for recurrent incontinence in elderly patients. Urology 1994; 43 (2): 203-208.

  16. Beck RP, McCormick S, Nordstrom L. The fascia lata sling procedure for treating recurrent genuine stress incontinence of urine. Obstetr Gynecol 1988; 72 (5): 699-703.

  17. Awad SA, Flood HD, Acker KL. The significance of prior anti-incontinence surgery in women who present with urinary incontinence. J Urol 1988; 140: 514-517.

  18. Govier FE, Gibbons RP, Correa RJ. Pubovaginal slings using fascia lata for the treatment of intrinsic sphincter deficiency. J Urol 1997; 157: 117-121.

  19. Cross CA, Cespedes RD, McGuire EJ. Our experience with pubovaginal slings in patients with stress urinary incontinence. J Urol 1998; 159: 1195-1198.

  20. McGuire EJ, Bennett CJ, Konnak JA, Sonda LP, Savastano JA. Experience with pubovaginal slings for urinary incontinence at the University of Michigan. J Urol 1987; 138: 525-526.

  21. Amaye-Obu FA, Drutz HP. Surgical Management of recurrent stress urinary incontinence: A 12-year experience. Am J Obstet Gynecol 1999; 181 (6): 1296-1309.

  22. Gormley EA, Bloom DA, McGuire EJ. Pubovaginal slings for the management of urinary incontinence in female adolescents. J Urol 1994; 152: 822-825.




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