Vaginal wall sling: Long-term outcome analysis of factors contributing to patient satisfaction and surgical success

Scott E. Litwiller, Roscoe S. Nelson, Patricia D. Fone, Kap B. Kim, Anthony R. Stone

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

Purpose: The clinical outcome of the vaginal wall sling was retrospectively evaluated to determine patient perception, satisfaction and factors contributing to postoperative success. Materials and Methods: An outcome based study was conducted of 51 patients undergoing construction of a vaginal wall sling for genuine stress incontinence or intrinsic sphincteric deficiency. Preoperative symptoms, demographic parameters and video urodynamic studies were correlated with postoperative patient perception of symptoms to determine patient satisfaction and factors contributing to overall success. Results: Of 42 patients (82%) available for followup 31 (74%) reported improvement in continence, 26 (62%) are currently satisfied with the urinary status, 72% in retrospect would repeat the procedure and 69% would recommend the vaginal wall sling to others. Despite long-term resolution of stress incontinence in 92% of those with genuine stress incontinence and 75% with intrinsic sphincter deficiency, postoperative urge incontinence was the single most important factor affecting patient satisfaction (p = 0.001). Patients without postoperative urge incontinence enjoyed the greatest levels of satisfaction, in excess of 90% (p = 0.001). Although preoperative leak point pressure correlated with resolution of stress incontinence, no preoperative demographic factors, symptoms or urodynamic parameters could reliably predict postoperative patient satisfaction. Conclusions: The vaginal wall sling represents an excellent option for the treatment of genuine stress incontinence and an acceptable option for intrinsic sphincteric deficiency. Patient perception and satisfaction remain closely associated with presence or resolution of postoperative urge incontinence. However, prediction of postoperative urge incontinence remains a challenge and should be considered when counseling patients preoperatively.

Original languageEnglish (US)
Pages (from-to)1279-1282
Number of pages4
JournalJournal of Urology
Volume157
Issue number4
DOIs
StatePublished - Apr 1997

Keywords

  • urinary incontinence, stress
  • urination disorders
  • vagina

ASJC Scopus subject areas

  • Urology

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