The surgical results of the pubovaginal sling procedure using Intravaginal Slingplasty (IVS) for stress urinary incontinence.

Objective: We investigated the surgical results and complications of the Intravaginal Slingplasty (IVS) procedure in women with stress urinary incontinence.

Patients And Methods: A total of 72 women with urethral hypermobility underwent the pubovaginal sling procedure using IVS with a mean age of 50.35+/-9.07 years. Average Body Mass Index, mean parity and daily mean pad usage was 29.2+/-3.5, 3.7+/-1.74 and 2.9+/-1.76, respectively. Preoperative urge incontinence was observed in 61.12% of the patients. The mean follow-up was 13.87+/-2.4 months. The operative time, postoperative urge symptoms, de novo detrusor instability and complications were all documented.

Results: The mean operating time was 25 min (18-40 min). Though postoperative first monthly controls proved 95.8% total dryness, the cure and improvement rates declined to 45.4% and 24.2% in 66 patients who completed 1 year of follow-up. The overall success and patient satisfaction rates were 69.6% and 87.5% respectively. De novo detrusor instability was observed in five patients (6.9%) whereas detrusor instability persisted in 25% of the patients. Bladder perforation and prolonged urinary retention developed in 11.1% of the patients. No signs of hematoma, infection and erosion were detected.

Conclusion: IVS is an easy procedure with low complication rates and it takes about 25 min. In spite of lower cure rates than the alternative surgical techniques, patient satisfaction rates seemed to be similar. Low cure rates may be due to either from inappropriate patient selection or from the biochemical and biomechanical properties of the polypropylene mesh. For this reason, randomized controlled trials and animal experiments should be evaluated for a further decision on the success rates.