Transvaginal bone-anchored sling procedure: 4 years of follow-up on more than 200 consecutive patients.

Objectives: To report intermediate-term results with reference to quality of life (QoL) and complications in 232 consecutive patients with stress urinary incontinence (SUI) treated with a transvaginal pubic bone-anchored sling (BAS).

Methods: We retrospectively reviewed 232 consecutive patients affected by SUI who underwent BAS using biologic and synthetic materials, with a mean follow-up of 50 months. Stress urinary incontinence was due to a defect of anatomic support and to intrinsic sphincteric deficiency in 220 patients and 12 patients, respectively. In all cases QoL was evaluated by Korman questionnaire.

Results: The questionnaire outcomes of 232 patients were evaluated. One hundred seventy-three patients (74.5%) reported being cured, 21 patients (9.0%) were unchanged, and 38 patients (16.5%) failed. One hundred seventy-seven patients (76.2%) were satisfied with the BAS procedure, and 38 (16.3%) would perhaps still choose BAS implantation, whereas 17 patients (7.5%) would not repeat this choice again. Sixty patients (25.8%) reported pelvic pain that was occasional in 47 patients (20.2%) and recurrent in 13 patients (5.6%). Twenty-five patients (14.1%) reported dyspareunia that was occasional in 17 patients (10.7%) and recurrent in 8 patients (3.4%).

Conclusions: The BAS procedure shows an overall acceptable subjective cure rate, even if in the presence of a high percentage of complications. In this setting the BAS procedure cannot be proposed for correction of SUI.